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Purpose: To assess associations between sedentary time (ST), physical activity (PA), and cardiovascular health in early childhood. Method: Cross-sectional study including 160 children (age 6.1 y [SD 0.5], 86 boys, 93 maternal body mass index ≥ 30 kg/m2, and 73 gestational diabetes) assessed for pulse wave velocity, echocardiography, ultra-high frequency 48–70 MHz vascular ultrasound, and accelerometery. Results: Boys had 385 (SD 53) minutes per day ST, 305 (SD 44) minutes per day light PA, and 81 (SD 22) minutes per day moderate to vigorous PA (MVPA). Girls had 415 (SD 50) minutes per day ST, 283 (SD 40) minutes per day light PA, and 66 (SD 19) minutes per day MVPA. In adjusted analyses, MVPA was inversely associated with resting heart rate (β = −6.6; 95% confidence interval, −12.5 to −0.7) and positively associated with left ventricular mass (β = 6.8; 1.4–12.3), radial intima-media thickness (β = 11.4; 5.4–17.5), brachial intima-media thickness (β = 8.0; 2.0–14.0), and femoral intima-media thickness (β = 1.3; 0.2–2.3). MVPA was inversely associated with body fat percentage (β = −3.4; −6.6 to −0.2), diastolic blood pressure (β = −0.05; −0.8 to −0.1), and femoral (β = −18.1; −32.4 to −0.8) and radial (β = −13.4; −24.0 to −2.9) circumferential wall stress in boys only. ST and pulse wave velocity showed no significant associations. Conclusions: In young at-risk children, MVPA is associated with cardiovascular remodeling, partly in a sex-dependant way, likely representing physiological adaptation, but ST shows no association with cardiovascular health in early childhood. [ABSTRACT FROM AUTHOR]

Aim: This randomized controlled trial compared the effects of a Conventional Exercise Program (CEP) and Culturally Relevant Activities (CRA) on body mass, cardiovascular risk, functional fitness (strength, flexibility, cardiorespiratory fitness, and agility), self-efficacy, and self-esteem in older women dwelling in Mozambique. Methods: Fifty-seven women (67 [7] y) underwent 60-minute sessions of CEP (n = 28) or CRA (n = 29) performed 3 days per week for 12 weeks. CRA included Mozambican traditional dances and games (intensity corresponding to scores 3–4 of BORG-CR10 scale), and CEP included 20-minute stationary cycling (65%–75% heart rate reserve) and a resistance training circuit (8 exercises, 15-repetition maximum). Results: CEP and CRA (P <.05) showed increased percent fat (3.4% and 5.3%), waist circumference (3.3% and 5.8%), and cardiorespiratory fitness (14.4% and 9.4%), and decreased triglycerides (−20.0% and −77.8%). In CEP (P <.05), body mass (2.9%), body mass index (3.2%), and high-density lipoprotein (10.0%) increased, while glycemia (−4.8%) and total cholesterol (−9.8%) decreased. Blood pressure slightly increased in CEP (6.2%, P >.05) and CRA (4.3%, P <.05). Self-efficacy and self-esteem increased to similar levels in both groups (15%, P <.05). Conclusions: CEP and CRA were capable to improve biopsychosocial health-related variables in Mozambican older women. Culturally referenced PA interventions should be considered as an alternative in African countries. [ABSTRACT FROM AUTHOR]

PURPOSE: Data are limited on sodium glucose co-transport 2 inhibitors (SGLT2-is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among real-world cohorts of underrepresented patients. We examined these therapies and glycemic control in US adults with diabetes mellitus (DM) by atherosclerotic cardiovascular disease (ASCVD) risk and sociodemographic factors. METHODS: In the NIH Precision Medicine Initiative All of Us Research Program, we categorized DM as (1) moderate risk, (2) high risk, and (3) with ASCVD. We examined proportions on DM therapies, including SGLT2-i or GLP-1 RA, and at glycemic control by sociodemographic factors and CVD risk groups. RESULTS: Our 81,332 adults aged ≥ 18 years with DM across 340 US sites included 22.3% non-Hispanic Black, 17.2% Hispanic, and 1.8% Asian participants; 31.1%, 30.3%, and 38.6% were at moderate risk, high risk, or with ASCVD, respectively. Those with DM and ASCVD were most likely on SGLT2-i (8.6%) or GLP-1 RA (11.9%). SGLT2-i use was

National- and international-level rugby sevens athletes are exposed to high training and competition loads over the course of a competitive season. Research on load monitoring and body-system responses is widespread; however, the primary focus has been on optimizing performance rather than investigating or improving cardiovascular health. There is a degree of cardiovascular remodeling, as well as local and systemic inflammation, in response to excessive exercise. These responses are moderated by many factors including previous exercise exposure, current exercise intensity and duration, age, race, and gender, as well as sport-specific physiology. For these reasons, high-performing female rugby sevens athletes may have a unique cardiovascular risk profile different from males and other rugby codes. This review aimed to characterize the training and competition loads, as well as the anthropometric and physiological profiles, of female rugby sevens athletes; discuss the potential impacts these may have on the cardiovascular system; and provide recommendations on future research regarding the relationship between rugby sevens training and competition loads and cardiovascular health. Movement demands, competition formatting, and training routines could all contribute to adverse cardiovascular adaptations. Anthropometric data and physiological characteristics may also increase the risk of cardiovascular disease. Future research needs to adopt measures of cardiovascular health to obtain a greater understanding of cardiovascular profiles and risk factors in female rugby sevens athletes. [ABSTRACT FROM AUTHOR]

Erectile dysfunction (ED) shares common risk factors with cardiovascular (CV) disease, such as a sedentary lifestyle, obesity, and metabolic syndrome. However, the relationship between ED and CV risk in Vietnam remains unknown. To investigate this, we conducted a multi-center observational study, randomly selecting 2,936 men aged 40 to 69 years in Vietnam, with 385 participants included after exclusions. The study evaluated the 10-year CV risk using the Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) score and assessed ED using the International Index of Erectile Function (IIEF-5) score. Results showed that men with diabetes mellitus and hypertension had significantly lower IIEF-5 scores compared to healthy individuals (18 [15–22] vs. 23 [20–24], p < 0.001). Additionally, the IIEF-5 score proved effective in identifying patients at very high CV risk, with an area under the curve (AUC) of 0.747, a cutoff point of 18.5, sensitivity of 69.6%, and specificity of 69.9%. Furthermore, we found a significant inverse correlation between SCORE2-Diabetes and IIEF-5 (ρ = -0.45 and p < 0.001). These findings establish a significant connection between ED and CV risk in men with diabetes, underscoring the need for integrated screening and management strategies to address both conditions concurrently. [ABSTRACT FROM AUTHOR]

The long-term health impacts of niacin are still debated, and the association between dietary niacin and mortality risk in populations hasn't been extensively explored. This study included 26,746 US adults aged 20 years or older from the National Health and Nutrition Examination Survey 2003–2018, with a median follow-up of 9.17 years. During this period, there were 3,551 all-cause deaths, including 1,096 cardiovascular deaths. Cox models were used to compare hazard ratios (HRs) for mortality among participants grouped into different dietary niacin intake quartiles. Participants with the highest dietary niacin intake had a lower risk of all-cause mortality (HR 0.74, 95%CI 0.63–0.86) compared to those in the lowest intake quartile. For cardiovascular mortality, the HR was 0.73 (95%CI 0.57–0.95) in the highest niacin intake quartile. A dose-response relationship was revealed between dietary niacin intake and mortality by restricted cubic spline. Subgroup analysis showed a significant interaction between dietary niacin intake and diabetes concerning all-cause mortality (P = 0.046). In this population-based cohort study, higher dietary niacin intake correlates with lower risk of all-cause and cardiovascular mortality among US adults. The influence of niacin intake on all-cause mortality appears to be more significant in non-diabetic individuals compared to those with diabetes. [ABSTRACT FROM AUTHOR]

Protein-energy wasting (PEW) is a major contributor to the high mortality among maintenance hemodialysis (MHD) patients. Cardiovascular disease (CVD) is the leading cause of death in dialysis patients, and PEW can significantly increase cardiovascular mortality in MHD patients. Previous studies have confirmed that PA may be a good objective indicator for determining the nutritional status and prognosis of MHD patients. Our study aimed to determine the predictive value of phase angle (PA) as detected by bioelectrical impedance analysis (BIA) on PEW and cardiovascular (CV) risk among MHD patients. Our retrospective observational study involved 161 adult patients with HD. The Cardiovascular risk score is a risk model based on the Japan Dialysis Outcome and Practice Patterns Study (J-DOPPS). We established LASSO logistic regression analysis model to identify key parameters related to body composition that can predict PEW in MHD patients. The area under the curve (AUC) values for PA, appendicular skeletal muscle mass index (ASMI), body cell mass (BCM), and mid-arm circumference (MAC) in predicting PEW in male MHD patients were relatively large, with 0.708, 0.674, 0.663, and 0.735, respectively. The predicted PEW values of these parameters were slightly lower in female patients than in men. We incorporated PA, ASMI, BCM, and MAC into a model that predicted the incidence of PEW in maintenance hemodialysis patients using LASSO technology. We discovered that the model predicted a greater AUC of PEW occurrence than any single factor, 0.877 for men and 0.76 for women. The results of the univariate logistic regression analysis showed that the low PA tertile array group had a greater incidence of PEW than the high PA group (P < 0.001). Additionally, we also found that lower PA was associated with higher CV risk scores. The PA detected by bioelectrical impedance analysis could predict the risk of PEW and cardiovascular events among patients with MHD. When used in conjunction, PA, ASMI, BCM, and MAC have a high diagnostic efficacy for PEW in patients on maintenance hemodialysis. [ABSTRACT FROM AUTHOR]

Background and objective: Retinal vein occlusion (RVO) and acute myocardial infarction (MI) are significant vascular events that impact patient health and mortality. Both conditions share common risk factors, such as hypertension, diabetes, and atherosclerosis. This study investigated the potential connection between RVO and MI, particularly among younger individuals, to improve preventive measures and management protocols. Method: A systematic review and meta-analysis were conducted, adhering to the PRISMA and MOOSE guidelines. Multiple databases, including PubMed, Scopus, MEDLINE, ScienceDirect, and ClinicalTrials.gov, were exhaustively searched until August 24, 2024. Studies were selected based on their reports of the association between RVO and MI risk. Quality assessment was performed using the Newcastle-Ottawa Quality Assessment Scale, and data were pooled using a random-effects model with hazard ratios and 95% confidence intervals. Result: Twelve studies comprising 371,817 participants were included. Meta-analysis revealed a pooled hazard ratio of 1.324 (95% CI, 1.238–1.415), indicating a significant association between RVO and increased MI risk (p = 0.0001). Subgroup analysis for central retinal vein occlusion (CRVO) showed a hazard ratio of 1.691 (95% confidence interval [CI] 1.142, 2.502, p = 0.009) with moderate heterogeneity (I2 = 36%), whereas branch retinal vein occlusion (BRVO) yielded a non-significant hazard ratio of 1.167 (95% CI 0.843, 2.106, p = 0.444; I2 = 33%). Publication bias was identified (Egger's test, p = 0.036) and addressed through trim-and-fill adjustment, maintaining statistical significance. Conclusion: Our meta-analysis shows a strong association between CRVO and a 69.1% increased risk of MI, while BRVO shows no significant correlation. Overall, RVO is linked to a 32.4% elevated risk of MI. Despite slight publication bias, adjusted analyses confirm reliability, indicating that improved cardiovascular monitoring for RVO patients, especially those with CRVO, is essential to mitigate MI risk. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major risk factor for cardiovascular disease (CVD), with a high prevalence in rural northeastern China. This study assesses the cardiovascular risk associated with different blood pressure patterns: systolic dominant, diastolic dominant, and parallel elevation. Methods: We analyzed data from the Northeast Rural Cardiovascular Health Study (NCRCHS), which included 8,189 participants aged 35 and above. Baseline surveys from 2012 to 2013 and follow-ups in 2015 and 2018 provided a median follow-up of 4.66 years. Participants were categorized into ten subgroups based on systolic and diastolic blood pressure elevations. Kaplan-Meier curves and Cox regression models were used to examine CVD incidence and cardiovascular risk across these groups. Results: The incidence of CVD varied significantly among hypertension categories. Patients with grade 1 hypertension had no significant increase in cardiovascular risk at nearly 5 years. Notably, parallel elevations in systolic and diastolic pressures posed the highest cardiovascular risk, while a predominant rise in diastolic pressure alone did not significantly increase risk. This highlights the importance of analyzing blood pressure comprehensively for cardiovascular risk stratification and suggests rethinking treatment strategies for diastolic dominant hypertension. Conclusions: Our findings call for a nuanced approach to cardiovascular risk assessment in hypertension, taking into account distinct patterns of systolic and diastolic blood pressure. The study supports personalized treatment interventions and reinforces current hypertension treatment guidelines. We advocate for prioritizing non-pharmacological management in grade 1 hypertension and further clinical evaluation of treatment thresholds for diastolic dominant hypertension. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose Methods Results Conclusions Previous studies have shown higher cardiovascular mortality risk with higher monocyte–lymphocyte ratio levels in general population. However, the levels of oxidative stress in individuals with type 2 diabetes are higher than those in the general population, which may affect the link between monocyte‐to‐lymphocyte ratio and cardiovascular disease deaths. And the association between the monocyte‐to‐lymphocyte ratio and mortality risk in people with type 2 diabetes still be unknown. This study aimed to investigate the prognostic significance of monocyte‐to‐lymphocyte ratio in type 2 diabetes.This analysis involved 2,954 individuals with type 2 diabetes from the National Health and Nutrition Examination Survey 1999–2010. The National Death Index records through December 31, 2019, was used to determine all‐cause and cardiovascular mortality. The prognostic roles were determined using Cox regression models, restricted cubic spline analysis, and time‐dependent receiver operating characteristic curve analysis.During an average follow‐up period of 12.4 years, a total of 1,007 deaths occurred, while 252 were due to cardiovascular disease. An elevated monocyte‐to‐lymphocyte ratio level exhibited a significant dose–response relationship with an increased risk of all‐cause mortality (1.34 [95% CI 1.12, 1.60] for all‐cause mortality [P trend = 0.001]). The multivariable‐adjusted HR was 1.81 (95% CI 1.25, 2.63) (P trend = 0.001) for cardiovascular mortality indicating a U‐shaped relationship (P nonlinear = 0.013).The results of this study indicate a U‐shaped relationship between the monocyte‐to‐lymphocyte ratio and cardiovascular mortality in individuals with diabetes. Both very low and high monocyte‐to‐lymphocyte ratio monocyte‐to‐lymphocyte ratio values were found to be associated with increased cardiovascular mortality risk. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to elucidate the differential immunological mechanisms and characteristics of hypertension induced by VEGF inhibitors (VEGFi) and VEGF receptor inhibitors (VEGFRi), with the goal of optimizing monitoring strategies and treatment protocols. Methods: We investigated the risk of immune-related adverse events associated with VEGFi/VEGFRi-induced hypertension by analyzing the FDA Adverse Event Reporting System (FAERS) database. Findings were corroborated with blood pressure characteristics observed in clinical patients and preclinical models exposed to various VEGF/VEGFRi. Clinical and preclinical studies were conducted to compare immunological responses and hypertension profiles between inhibitor classes. An integrative analysis across cancer types and species was performed, focusing on key signaling pathways. Results: Analysis of FAERS data, in conjunction with clinical observations, revealed that both VEGFi and VEGFRi significantly elevated the risk of immune-mediated, blood pressure-related adverse events (ROR=7.75, 95% CI: 7.76-7.95). Subsequent clinical and preclinical studies demonstrated differential immunological responses and hypertension profiles between inhibitor classes. VEGFRi exhibited a more rapid onset, greater blood pressure elevation, and higher incidence of immune-mediated adverse events compared to VEGFi (Systolic BP: ROR=0 for VEGFi vs. ROR=12.25, 95% CI: 6.54-22.96 for VEGFRi; Diastolic BP: ROR=5.09, 95% CI: 0.60-43.61 for VEGFi vs. ROR=12.90, 95% CI: 3.73-44.55 for VEGFRi). Integrative analysis across cancer types and species, focusing on key signaling pathways, revealed that VEGF/VEGFRi-induced blood pressure elevation was associated with immunomodulation of the mitogen activated protein kinase (MAPK) pathway (R=-0.379, P=0.0435), alterations in triglyceride metabolism (R=-0.664, P=0.0001), modulation of myo-inositol 1,4,5-trisphosphate-sensitive calcium release channel activity (R=0.389, P=0.0378), and dysregulation of nitric oxide eNOS activation and metabolism (R=-0.439, P=0.0179). Discussion: The temporal dynamics of these effects demonstrated greater significance than dose-dependent responses. Both VEGFi and VEGFRi significantly augmented the risk of immune-mediated, blood pressure-related adverse events, with VEGFRi inducing a more rapid and pronounced onset of blood pressure elevation and a higher incidence of immune-related, blood pressure-associated adverse events compared to VEGFi. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Low-density lipoprotein receptor-related protein-2 (LRP2), also called megalin, is a multi-ligand receptor of the LDL receptor gene family mediating reabsorption of ligands like Apo-A1. Type 2 diabetes mellitus (T2DM) may possibly disrupt megalin functions as it is found to be regulated by insulin. This might cause cardiovascular complications due to derangement in lipoprotein metabolism. The current study was carried out to assess the serum megalin levels among T2DM individuals with cardiovascular complications in the Indian population. Methods: This was a cross-sectional study involving 80 patients with T2DM. 40 T2DM patients with known cardiovascular disease were selected as cases and 40 of those without evidence of cardiovascular disease were selected as controls. Demographic details, DM duration and class of oral hypoglycemic agents (OHA) used were collected from medical records while details of lipid profile, fasting glucose, serum creatinine and urea were collected from laboratory information system. Serum megalin levels were estimated using left-over samples by ELISA. Results: The study groups showed no statistical significance in baseline laboratory parameters except for serum creatinine and low density lipoprotein cholesterol (LDL-c). Mean serum megalin levels were statistically insignificant between cases and controls (0.91 ± 0.78 ng/mL vs. 0.85 ± 0.69 ng/mL, P 0.74).The subgroup analysis of serum megalin levels based on OHA consumption among cases was also statistically insignificant (P 0.056). Pearson's correlational analysis was statistically insignificant between serum megalin and lipid profile parameters among cases (P > 0.05). Conclusion: Serum megalin alone may not serve as a biomarker for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Recent studies indicate that intensive blood pressure (BP) targets can be reached with less than two medications. This cross‐sectional study, involving 4991 individuals from the Majiapu community, assessed the correlation between BP control and the burden of antihypertensive drugs. Participants on medication were categorized into controlled (BP < 140/90 mm Hg) and uncontrolled (BP ≥ 140/90 mm Hg) groups, with the former further divided into optimal (BP < 130/80 mm Hg) and good control (BP < 140/90 but >130/80 mm Hg) subgroups. Multivariate logistic regression analyzed factors affecting hypertension control across these BP categories. The study found that, 54% of participants had hypertension. Of those treated (62.5%), 55.7% achieved BP control, including 23.15% maintaining BP below 130/80 mm Hg. The average number of antihypertensive medications was 1.61 for the controlled group (with an average BP of 126.6/76 mm Hg) and 1.75 for the uncontrolled group (with an average BP of 150.6/84.0 mm Hg). Additionally, the average number of antihypertensive medications was 1.66 in the good control group and 1.55 in the optimal control group. The uncontrolled group had a higher mean systematic coronary risk estimation (SCORE) of 5.59, against 3.97 and 2.5 in the good and optimal control groups, respectively. Key factors linked to poor BP control included age over 65, male sex, obesity, and former smoking, whereas lipid‐lowering medication use was associated with better control. In conclusions, patients needing fewer antihypertensive drugs to achieve stricter targets may have a lower risk profile. Notably, only a small proportion of treated patients are low‐risk individuals who can easily achieve BP levels below 130/80 mm Hg. [ABSTRACT FROM AUTHOR]

Background/Objectives: The impact of alcohol consumption and its restriction on clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) remains elusive. We aimed to investigate the clinical outcomes in drinkers undergoing PCI. Methods: We included 77,409 patients who underwent PCI and a health check-up within one year of the PCI using a nationwide prospective database from the Korean National Health Insurance System. Primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause mortality, myocardial infarction, coronary revascularization, and stroke. Patients were classified as non-drinkers, within-the-guideline (≤1 standard drink in women and ≤2 in men), and above-the-guideline drinkers based on drinking status at the first health check-up after PCI. Results: During a 4.0-year follow-up duration, MACCE incidence was 19.7% (n = 15,214) (4689 [6.1%] deaths, 1916 [2.5%] MI, 2033 [2.6%] strokes, and 10,086 [13.0%] revascularizations). Both within-the-guideline- (aHR [95%CI], 0.843 [0.773–0.919]) and above-the-guideline drinkers (0.829 [0.784–0.876]) had a lower MACCE risk than the non-drinkers. A characteristic J-curve relationship was observed between the frequency or body weight-adjusted alcohol consumption and MACCE risk, with the lowest risk in the once-per-week and a mild amount per body weight (≤0.33 g/kg/week) group. Drinking habits after PCI were associated with a lower risk of adverse cardiovascular outcomes; those who continued to drink before and after PCI had the lowest risk. Conclusions: Alcohol consumption was associated with a lower risk of adverse outcomes in patients undergoing PCI. Further studies with longer-term follow-up are warranted. [ABSTRACT FROM AUTHOR]

Copyright of Lege Artis Medicine (LAM) is the property of LifeTime Media Kft. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This review aimed to investigate the prevalence of hypertension and cardiovascular (CV) complications in various inflammatory and autoimmune diseases (IAD). Recent Findings: Despite recent improvements in the management of IAD, patients with IAD still have an increased CV mortality and CV complications, mostly related to CV risk factors such as hypertension and inflammation. Summary: We systematically searched MEDLINE and EMBASE libraries for controlled studies involving hypertension and CV complications in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriasis including psoriatic arthritis (PsA), Sjogren's syndrome (SS), or antineutrophil cytoplasmic antibody-associated vasculitis (AAV) between January 2000 and March 2022. We extracted data on the prevalence of hypertension and CV complications. Then, random-effects meta-analyses and exploratory multivariate meta-regression were performed to explore factors related to the prevalence of hypertension. Of 2726 studies screened, 122 were selected for the meta-analysis. The prevalence of hypertension was higher among patients with IAD than controls, with an overall unadjusted odds ratio (OR) [95% confidence interval] of 1.67 [1.58–1.76] and an adjusted OR of 1.36 [1.24–1.50]. All diseases were found to be associated with increased risk of hypertension: SLE, adjusted OR 3.40 [1.93–6.00]; psoriasis, OR 1.32 [1.16–1.51]; PsA, OR 1.49 [1.15–1.94]; RA, OR 1.28 [1.04–1.58]; SS, OR 2.02 [1.19–3.44]. Age and female sex were significantly associated with hypertension in patients with IAD. The risk of CV complications was increased: ischemic heart disease, adjusted OR 1.38 [1.21–1.57]; cerebrovascular disease, OR 1.37 [1.03–1.81]; heart failure, OR 1.28 [1.05–1.55]; atherosclerotic plaques presence, OR 2.46 [1.84–3.29]. The prevalence of hypertension and CV complications is higher among patients with IAD. Screening and management of hypertension appears to be of paramount importance in these patients. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1RA) in patients with type 2 diabetes mellitus (T2DM) in clinical practice. Research design and methods: A total of 340 patients were included. Data on age, gender, antidiabetic medications, and bioanalytical parameters were collected at baseline and one year later. Were analyzed estimated glomerular filtration rate (eGFR), blood sodium and potassium levels, blood pressure, weight, cardiovascular risk, and glycated hemoglobin (HbA1c). Results: Patients treated with SGLT2i exhibited a significant improvement in eGFR at the endpoint compared to baseline (p = 0.006). Both treatment groups experienced reductions in systolic blood pressure at the endpoint; especially patients treated with SGLT2i (p = 0.0002). GLP1RA treatment resulted in a statistically significant weight reduction from baseline to endpoint (p < 0.0001), with a higher percentage of patients achieving ≥ 5% weight loss compared to the non-GLP1RA group (33.6% vs. 19.8%). Both SGLT2i and GLP1RA treatments significantly reduced cardiovascular risk scores (p = 0.004 and p = 0.002, respectively). Additionally, both treatments were associated with a significant reduction in HbA1c levels at the endpoint (p = 0.010 and p = 0.002, respectively). Conclusions: Our findings suggest that SGLT2i and GLP1RA offer beneficial effects in patients with T2DM. [ABSTRACT FROM AUTHOR]

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background The familial hypercholesterolemia (FH) diagnosis is based on clinical and genetic criteria. A relevant proportion of FH patients fulfilling the criteria for definite FH have negative genetic testing. Increasing the identification of true genetic-based FH is a clinical challenge. Deepening the analysis of lipoprotein alterations could help increase the yield of genetic testing. We evaluated whether the number, size, and composition of lipoproteins assessed by 1H-NMR could increase the identification of FH patients with pathogenic gene variants. Methods We studied 294 clinically definite FH patients, 222 (75.5%) with positive genetic testing, as the discovery cohort. As an external validation cohort, we studied 88 children with FH, 72 (81%) with positive genetic testing. The advanced lipoprotein test based on 1H-NMR (Liposcale®) was performed at baseline after a lipid-lowering drug washout of at least 6 weeks. The association of variables with genetic variants was evaluated by random forest and logistic regression. Areas under the curve (AUCs) were calculated. A predictive formula was developed and applied to the validation cohort. Results A formula derived from nuclear magnetic resonance (NMR) lipoprotein analyses improved the identification of genetically positive FH patients beyond low-density lipoprotein (LDL)-cholesterol levels (AUC = 0.87). The parameters contributing the most to the identification formula were LDL particle number, high-density lipoprotein size, and remnant cholesterol. The formula also increases the classification of FH children with a pathogenic genetic variation. Conclusion NMR lipoprotein profile analysis identifies differences beyond standard lipid parameters that help identify FH with a positive pathogenic gene variant, increasing the yield of genetic testing in FH patients. [ABSTRACT FROM AUTHOR]

Serum neurofilament light chain (sNFL) is a biomarker for axonal injury. Previous studies have linked sNFL levels to cardiovascular risk factors such as diabetes and hypertension, but its association with cardiovascular diseases (CVD) remains unclear. This study aims to explore the association between sNFL and CVD and evaluates its predictive value. Utilizing NHANES 2013–2014 data, this study included 2,035 participants aged ≥ 20 years with measured sNFL quantified using a Siemens immunoassay. CVD was self-reported and included myocardial infarction, stroke, heart failure, coronary heart disease, or angina. Logistic regression models assessed the association between sNFL levels and CVD. The predictive value of sNFL for CVD was evaluated using area under the curve (AUC) and DeLong test. Participants with higher sNFL levels were typically older, male, non-Hispanic white, smokers, and had lower socioeconomic status, higher CVD, hypertension, and diabetes prevalence. Higher sNFL levels were significantly associated with increased odds of CVD (adjusted OR = 1.41, 95% CI: 1.05–1.88). The association was significant in non-hypertensive individuals (OR = 2.72, 95% CI: 1.61–4.62) but not in hypertensive individuals (OR = 1.13, 95% CI: 0.81–1.56). sNFL addition to traditional risk models improved predictive accuracy, especially in non-hypertensive individuals (AUC from 0.827 to 0.856). sNFL levels are significantly associated with CVD in the general population, with a strong predictive value in non-hypertensive individuals. Future longitudinal studies should validate sNFL's efficacy in various populations and explore the underlying mechanisms of its relationship with hypertension and CVD. [ABSTRACT FROM AUTHOR]

Background: Understanding genetic-metabolite associations has translational implications for informing cardiovascular risk assessment. Interrogating functional genetic variants enhances our understanding of disease pathogenesis and the development and optimization of targeted interventions. Methods: In this study, a total of 187 plasma metabolite levels were profiled in 4974 individuals of European ancestry of the GCAT| Genomes for Life cohort. Results of genetic analyses were meta-analysed with additional datasets, resulting in up to approximately 40,000 European individuals. Results of meta-analyses were integrated with reference gene expression panels from 58 tissues and cell types to identify predicted gene expression associated with metabolite levels. This approach was also performed for cardiovascular outcomes in three independent large European studies (N = 700,000) to identify predicted gene expression additionally associated with cardiovascular risk. Finally, genetically informed mediation analysis was performed to infer causal mediation in the relationship between gene expression, metabolite levels and cardiovascular risk. Results: A total of 44 genetic loci were associated with 124 metabolites. Lead genetic variants included 11 non-synonymous variants. Predicted expression of 53 fine-mapped genes was associated with 108 metabolite levels; while predicted expression of 6 of these genes was also associated with cardiovascular outcomes, highlighting a new role for regulatory gene HCG27. Additionally, we found that atherogenic metabolite levels mediate the associations between gene expression and cardiovascular risk. Some of these genes showed stronger associations in immune tissues, providing further evidence of the role of immune cells in increasing cardiovascular risk. Conclusions: These findings propose new gene targets that could be potential candidates for drug development aimed at lowering the risk of cardiovascular events through the modulation of blood atherogenic metabolite levels. [ABSTRACT FROM AUTHOR]

Background Method Results Conclusion Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) have been shown to improve cardiovascular outcomes by reducing low‐density lipoprotein cholesterol (LDL‐C). However, sex differences in the efficacy of evolocumab remain unclear. This study aimed to investigate sex differences in the efficacy of evolocumab using real‐world data.Data were collected from the First Affiliated Hospital of Guangxi Medical University. A total of 416 eligible patients were selected from 1463 patients treated with evolocumab for secondary prevention. Clinical data, including individual characteristics and lipids profiles, were recorded. Propensity score matching (PSM) was used to control for potential confounders, with covariates including age, body mass index, smoking status, and diabetes. All eligible participants were propensity‐matched 1:1 for female versus male with a match tolerance of 0.02. The efficacy of evolocumab in females and males was compared by PSM‐adjusted analysis.In the PSM analysis, a significant difference was found in the relative percentage reduction of LDL‐C between females and males (−42.7% vs. −54.4%, p < 0.001). In addition, the absolute LDL‐C reduction was lower in females compared to males (interquartile range: −1.5 [−2.2, −0.8] mmol/L vs. −1.9 [−2.5, −1.0] mmol/L, p = 0.018). The rate of target LDL‐C attainment was lower in females than in males after treatment with evolocumab (21.6% vs. 39.8%, p = 0.009).These results suggest that males have a better response to evolocumab in term of LDL‐C reduction compared to females. [ABSTRACT FROM AUTHOR]

Background: The Steno Type 1 Risk Engine (ST1RE) was developed to aid clinical decisions in primary prevention for individuals with type 1 diabetes (T1D), as existing cardiovascular (CV) risk models for the general population and type 2 diabetes tend to underestimate CV risk in T1D. However, the applicability of ST1RE in different populations remains uncertain, as prediction models developed for one population may not accurately estimate risk in another. This study aimed to evaluate the performance of the ST1RE in predicting CV events among ethnically mixed T1D individuals and its association with the progression of microangiopathy complications. Methods: A retrospective survey of 435 adults with T1D who were free of CV events at baseline was assessed by ST1RE and chronic diabetes complications at 5 and 10 years of follow-up. The estimated CV risk rates were compared with the observed rates at 5 and 10 years using statistical analyses, including Receiver Operating Characteristic (ROC) curve analysis, Hosmer-Lemeshow test, Kaplan-Meier curves analysis and Cox-regression models. Results: Among 435 patients (aged 25 years; interquartile range [IQR]: 21–32) with a median T1D duration of 13 years (IQR: 9–18), only 5% were categorized into the high ST1RE group. Within a median follow-up of 9.2 years (IQR 6.0-10.7), 5.5% of patients experienced a CV event (1.6%, 14.9%, and 50% from the low, moderate, and high-risk groups, respectively). The hazard ratios (HRs) for CV events were greater in the high-risk group (HR 52.02; 95% CI 18.60–145.51, p < 0.001) and in the moderate-risk group (HR 8.66; 95% CI 2.90–25.80, p < 0.001) compared to the low-risk group. The ST1RE estimated CV events were similar to the observed at 5 years (3.4% vs. 3.5%; χ2 = 10.12, p = 0.899) and 10 years (6.8% vs. 9.9%; χ2 = 14.80, p = 0.676) of follow-up. The progression of microangiopathies was greater in the high vs. low for retinopathy (p = 0.008), diabetic kidney disease (p < 0.001), peripheral neuropathy (p = 0.021), and autonomic neuropathy (p = 0.008). Conclusions: ST1RE performed well in predicting CV events at 5 and 10 years of follow-up. Moreover, higher ST1RE scores were associated with the progression of microangiopathy complications in this genetically heterogeneous T1D population. [ABSTRACT FROM AUTHOR]

Summary: An Italian multidisciplinary working group discussed the current Italian scenario of osteoporosis management during a meeting and highlighted the essential role of calcium and vitamin D supplementation in the prevention of fragility fractures. Purpose: This paper aims to review and discuss data on calcium and vitamin D requirements and the role of combined calcium and vitamin D supplementation in the treatment of patients with osteoporosis. Methods: The discussion of the experts covered literature data on calcium and vitamin D supplementation, gaps in the diagnosis and treatment of osteoporosis, and the role of the primary care physician in identifying and treating patients with osteoporosis. Articles for consideration were identified through PubMed searches using different combinations of pertinent keywords. Results: The discussion highlighted that insufficient calcium or vitamin D intake increases the risk of fragility fractures. The experts also drew attention to the essential role of calcium and vitamin D supplementation in achieving an anti-fracture effect and supporting the efficacy of anti-osteoporotic agents without increasing nephrolithiasis and cardiovascular risks. In addition, the discussion underlined the role of the primary care physician in the initial clinical approach to patients with osteoporosis. Conclusions: The experts believe that efficient treatment for patients with osteoporosis should include calcium and vitamin D supplementation to achieve adequate levels that are able to inhibit the parathyroid hormone and bone resorption. [ABSTRACT FROM AUTHOR]

Kidney disease is linked to the development of cardiovascular disorders, further increasing morbidity and mortality in this high-risk population. Thus, early detection of myocardial damage is imperative in order to prevent devastating cardiovascular complications within this patient group. Over the years, cardiac biomarkers have been identified and are now widely used in everyday clinical practice. More specifically, available data suggest that cardiac troponin and its regulatory subunits (TnT, TnI, and TnC) reflect the injury and necrosis of myocardial tissue. While cTnC is identical in cardiac and skeletal muscle, TnT and TnI constitute cardiac-specific forms of troponin, and, as such, they have been established by international societies as biomarkers of cardiac damage and diagnostic indicators for acute myocardial infarction. Elevations in the levels of both cardiac troponins (cTnT and cTnI) have been also reported in asymptomatic patients suffering from chronic kidney disease. Therefore, if abnormal, they often generate confusion among clinicians regarding the interpretation and clinical significance of their numerical values in emergency settings. The aim of this review is to explore the reasons behind elevated troponin levels in patients with chronic kidney disease and identify when these elevated levels of biomarkers indicate the need for urgent intervention, considering the high cardiovascular risk in this patient group. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the association between sarcopenic obesity and arterial stiffness using bioelectrical impedance analysis (BIA). Methods: This retrospective cross-sectional study included 20,601 Korean adults from January 2016 to December 2023. Sarcopenia was defined as height-adjusted appendicular skeletal muscle mass [(ASM/height2) <5.7 in women and <7.0 in men] using BIA. Obesity was defined by body mass index or waist circumference. Arterial stiffness was assessed by measuring brachial-ankle pulse wave velocity (baPWV). The participants were categorized into four groups: normal, sarcopenia, obesity, and sarcopenic obesity. The baPWV values were compared among the four groups to investigate the association between sarcopenic obesity and arterial stiffness using adjusted multivariate analyses. Results: The mean baPWV of the sarcopenic obesity group was higher (p < 0.001) than that of the other groups. The odds ratio for having high baPWV (>1800 cm/s) in the sarcopenic obesity group was 2.40 (95% CI, 1.07–5.38) after adjusting for age, sex, exercise, smoking, heavy alcohol consumption, hypertension, and dyslipidemia. Conclusions: Sarcopenic obesity was independently associated with increased arterial stiffness. [ABSTRACT FROM AUTHOR]

Endometriosis is a prevalent gynecological condition, affecting around 10% of reproductive-age women. Inflammatory processes associated with endometriosis may contribute to endothelial dysfunction. Increased skin accumulation of advanced glycation end-products (AGEs), reflecting arterial stiffness, potentially links endometriosis with elevated risk of cardiovascular events. We hypothesized that patients with endometriosis have impaired endothelial function as well as increased arterial stiffness and AGE skin accumulation, compared to healthy controls. We compared endothelial function, arterial stiffness, and levels of AGEs in patients suffering from endometriosis and in healthy controls. The study included 45 women aged 20 to 40: 21 patients with endometriosis and 24 healthy controls, matched in terms of age, BMI, and blood pressure values. Endo-PAT 2000 device was used for non-invasive assessment of (i) endothelial function, expressed as Reactive Hyperemia Index (RHI), and (ii) arterial stiffness, expressed as Augmentation Index (AI) and Augmentation Index at 75 heart beats/min (AI@75). Endothelial dysfunction was defined as an RHI value ≤ 1.67. AGE Reader device was used for non-invasive evaluation of skin AGE level accumulation. Patients with endometriosis had lower mean RHI values (1.69 ± 0.54 vs. 2.02 ± 0.48, p = 0.037) and a higher prevalence of endothelial dysfunction, (52.4% vs. 20.8%, p = 0.027) compared to healthy controls. Skin AGE level was higher in patients with endometriosis, compared to controls (2.00 ± 0.57 vs. 1.70 ± 0.24, p = 0.013). There were no significant differences in AI and AI@75 between the two groups. Patients with endometriosis have impaired endothelial function and higher AGE skin accumulation, which are well-established preclinical manifestations of increased cardiovascular risk. There is a great need for comprehensive cardiovascular risk assessments in women with endometriosis to prevent the development of potential atherosclerotic-based complications. [ABSTRACT FROM AUTHOR]

Background/Objectives: Dietary habits are among the most significant determinants of health. The aim of this study was to assess the nutritional quality and cardiovascular profiles of individuals following plant-based diet. Methods: The study population comprised 199 individuals (136 women, 63 men; mean age 33.9  ±  8.9 years) including vegans (VG; n = 50), vegetarians (VN; n = 101) and omnivores (OV; n = 48). In this analysis the following procedures were assessed: a questionnaire interview, anthropometric and blood pressure measurements, and a blood sample collection. Dietary patterns were evaluated using the Food Frequency Questionnaire and a 24-h dietary recall. Results: Vegans exhibited the lowest protein intake relative to the other groups (p < 0.05) and a significantly higher intake of polyunsaturated fatty acids and lower intake of cholesterol compared to VN and OV (p < 0.05). Vegans had significantly lower levels of serum cholesterol, LDL cholesterol, and triglycerides, fasting glucose and high-sensitivity C-reactive protein (p < 0.05). No cases of overweight or obesity were observed among VN and VG participants. No instances of impaired fasting glucose or elevated blood pressure were noted among vegans. Hypercholesterolemia was identified in 56.2% of OV, 26.7% in VN and 16.0% in VG (p < 0.05), elevated blood pressure was recorded in one vegetarian and in 6.2% of OV participants. Conclusions: Our research indicates that plant-based diets are associated with a better cardiovascular profile compared to traditional diets. Moreover, suboptimal intake of essential nutrients, underscores the need for more effective public health interventions and improved nutrition education regardless of dietary patterns. [ABSTRACT FROM AUTHOR]

Introduction: Studies have shown the relative cardiovascular safety of hormone replacement therapy (HRT) for women in the general population. Evidence on women with diabetes remains scarce. We aimed to investigate the risk of cardiovascular disease (CVD) in menopausal women with diabetes who use HRT compared to non-users. Methods: Search across Medline, Embase, Web of Sciences, and Cochrane databases up to November 2023 was conducted. We combined keywords of menopause, diabetes, HRT, and various CVD outcomes. Non-English studies, observational studies other than cohort and case–control, reviews, and conference abstracts were excluded. Bias was checked using validated risk-of-bias tools. Random-effects model was used to calculate pooled relative risks (RR) for similar outcomes. Results: Out of 7625 identified articles, 19 (6 clinical trials and 13 observational studies) were included, primarily from Europe and the U.S.A. Most studies had moderate risk of bias. Meta-analysis of myocardial infarction (MI) risk from nine observational studies (n = ~34,626) showed a pooled RR of 0.83 (95% CI 0.62–1.12). Limited data precluded meta-analysis for the clinical trials and other outcomes from observational studies. Conclusions: Observational studies do not suggest an increased risk of MI in menopausal women with diabetes prescribed HRT. Further research with a more robust method is warranted to validate this finding. Prospero registration number: CRD42023479335 [ABSTRACT FROM AUTHOR]

The idiopathic inflammatory myopathies encompass a diverse array of autoimmune diseases, characterized by muscular inflammation and various extramuscular manifestations. These conditions have the potential to impact multiple organs, including the lungs, skin, joints, gastrointestinal tract, and heart. The defining features of these conditions are muscle weakness and myalgia. Although cardiac involvement is infrequent, its clinical manifestations are subtle and easily overlooked. Cardiac damage represents a significant contributor to mortality and morbidity in patients with idiopathic inflammatory myopathy. Early and accurate identification of cardiac involvement may facilitate improved patient outcomes. This article provides an overview of the potential etiology, clinical presentations, risk factors, biomarkers, and imaging studies for early diagnosis of cardiac involvement in idiopathic inflammatory myopathy. This review aims to enhance clinicians' understanding and diagnostic capabilities regarding cardiac involvement in idiopathic inflammatory myopathy while promoting early intervention strategies for lifelong management and improved prognosis. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) poses significant health risks due to its asymptomatic nature in early stages and its association with increased cardiovascular and kidney events. Early detection and management are critical for improving outcomes. Objective: This study aimed to develop and validate a prediction model for hospitalization for ischemic heart disease (IHD) or cerebrovascular disease (CVD) and major kidney events in Japanese individuals with mild CKD using readily available health check and prescription data. Methods: A retrospective cohort study was conducted using data from approximately 850,000 individuals in the PREVENT Inc. database, collected between April 2013 and April 2023. Cox proportional hazard regression models were utilized to derive and validate risk scores for hospitalization for IHD/CVD and major kidney events, incorporating traditional risk factors and CKD-specific variables. Model performance was assessed using the concordance index (c-index) and 5-fold cross-validation. Results: A total of 40,351 individuals were included. Key predictors included age, sex, diabetes, hypertension, and lipid levels for hospitalization for IHD/CVD and major kidney events. Age significantly increased the risk score for both hospitalization for IHD/CVD and major kidney events. The baseline 5-year survival rates are 0.99 for hospitalization for IHD/CVD and major kidney events are 0.99. The developed risk models demonstrated predictive ability, with mean c-indexes of 0.75 for hospitalization for IHD/CVD and 0.69 for major kidney events. Conclusions: This prediction model offers a practical tool for early identification of Japanese individuals with mild CKD at risk for hospitalization for IHD/CVD and major kidney events, facilitating timely interventions to improve patient outcomes and reduce healthcare costs. The models stratified patients into risk categories, enabling identification of those at higher risk for adverse events. Further clinical validation is required. [ABSTRACT FROM AUTHOR]

Arterial stiffness (AS) is a significant risk factor for cardiovascular diseases, which are the leading cause of death in developed countries. Based on the measurement of AS among residents supplied with soft drinking water (100 respondents) and hard water (100 respondents), a significant difference was found in the pulse wave velocity (PWVao), arterial age, and the difference between arterial and actual age (delta – Δ age). Among respondents consuming soft drinking water, PWVao was higher by 1.9 ms-1, arterial age was higher by 23 years, and Δ age was higher by 14.5 years. As an intervention, originally soft drinking water was treated to increase calcium (Ca) and magnesium (Mg) content by approximately 10–15 mg l-1 . After 18 months of consuming water with elevated Ca and Mg content, PWVao decreased by 0.93 m s-1, arterial age decreased by 10.42 years, and Δ age decreased by 11.79 years among respondents originally consuming soft drinking water. Thus, their risk of developing CVD was significantly reduced. [ABSTRACT FROM AUTHOR]

Nocturnal sympathetic overdrive is an early indicator of cardiovascular (CV) disease, emphasizing the importance of reliable remote patient monitoring (RPM) for autonomic function during sleep. To be effective, RPM systems must be accurate, non-intrusive, and cost-effective. This review evaluates non-invasive technologies, metrics, and algorithms for tracking nocturnal autonomic nervous system (ANS) activity, assessing their CV relevance and feasibility for integration into RPM systems. A systematic search identified 18 relevant studies from an initial pool of 169 publications, with data extracted on study design, population characteristics, technology types, and CV implications. Modalities reviewed include electrodes (e.g., electroencephalography (EEG), electrocardiography (ECG), polysomnography (PSG)), optical sensors (e.g., photoplethysmography (PPG), peripheral arterial tone (PAT)), ballistocardiography (BCG), cameras, radars, and accelerometers. Heart rate variability (HRV) and blood pressure (BP) emerged as the most promising metrics for RPM, offering a comprehensive view of ANS function and vascular health during sleep. While electrodes provide precise HRV data, they remain intrusive, whereas optical sensors such as PPG demonstrate potential for multimodal monitoring, including HRV, SpO2, and estimates of arterial stiffness and BP. Non-intrusive methods like BCG and cameras are promising for heart and respiratory rate estimation, but less suitable for continuous HRV monitoring. In conclusion, HRV and BP are the most viable metrics for RPM, with PPG-based systems offering significant promise for non-intrusive, continuous monitoring of multiple modalities. Further research is needed to enhance accuracy, feasibility, and validation against direct measures of autonomic function, such as microneurography. [ABSTRACT FROM AUTHOR]

Introduction: Atherosclerosis is a leading cause of cardiovascular disease, characterized by lipid accumulation and chronic inflammation within arterial walls. Early detection in young adults is crucial for preventing adverse cardiovascular events. This study investigates the associations between inflammatory indices, lipid biomarkers, and the presence of atherosclerosis in patients aged 18 to 55 years. Methods: A cross-sectional study was conducted involving 89 participants divided into two groups: 62 patients with documented atherosclerosis (main group) and 27 healthy controls without significant atherosclerosis. Comprehensive data—including demographic information, medication use, imaging results, laboratory parameters, and calculated inflammatory indices (SIRI, SII, AISI, NLR, PLR, MLR)—were collected. Statistical analyses included correlation assessments, group comparisons using the Mann–Whitney U test, logistic regression modeling, feature importance analysis with Random Forest and Gradient Boosting classifiers, receiver operating characteristic (ROC) curves, and K-means clustering. Results: Significant differences were observed between the main and control groups. Patients with atherosclerosis exhibited elevated inflammatory indices (SIRI, NLR, MLR, SII) and lipid profile abnormalities (higher TC and LDL-C, lower HDL-C). Lp(a) and ANGPTL3 levels were significantly higher in the main group (p < 0.001 and p < 0.01, respectively). Logistic regression identified SIRI and ANGPTL3 as significant predictors of atherosclerosis, with the model demonstrating high accuracy (77%) and sensitivity (93%). Feature importance analysis confirmed the significance of SIRI and ANGPTL3, alongside traditional lipid biomarkers, in predicting disease presence. ROC analysis showed excellent model performance (AUC > 0.80). Clustering analysis revealed two distinct patient subgroups characterized by predominant inflammatory profiles or lipid metabolism disturbances. Conclusions: Systemic inflammation and lipid abnormalities play significant roles in early atherosclerosis among young adults. Elevated SIRI and ANGPTL3 levels are potent predictors of disease presence. The integration of inflammatory indices and lipid biomarkers into predictive models enhances risk stratification and supports personalized medicine approaches. [ABSTRACT FROM AUTHOR]

Background: Recent data from European studies (EUROASPIRE V, DA VINCI, SANTORINI) indicate that achieving the LDL cholesterol (LDL-C) target in patients at very high cardiovascular risk is uncommon. Additionally, using a combination therapy involving statins and ezetimibe remains infrequent. Methods: A single-center assessment of a pre-defined lipid lowering treatment algorithm's effectiveness at achieving the LDL-C target in patients at very high cardiovascular risk one month and one year after hospitalization. Results: 81 patients were included, all in secondary prevention. The average age of the patient was 66.9 years, and the main cardiovascular risk factors included hypertension, diabetes mellitus, and smoking history. Following the predefined lipid-lowering algorithm specific to our study, which involves initiating high-intensity statin therapy or a combination of statin and ezetimibe depending on initial LDL-C levels and patient history; 30 (37%) patients initiated high-intensity statin therapy (Atorvastatin (40 mg, 80 mg) or Rosuvastatin (20 mg, 40 mg)), while 51 (63%) started combination therapy with high-intensity statin and ezetimibe 10 mg. After one year, 57 (70.4%) remained adherent to their initial treatment, achieving a mean LDL-C of 49.5 ± 16.9 mg/dL, with 36 (63.2%) of them reaching the LDL-C target of <55 mg/dL. A total of 13 patients discontinued treatment, and 9 were lost to follow-up, withdrew from the study, or died. Conclusion: Initiating dual statin and ezetimibe therapy or high-intensity statin therapy early, based on the expected treatment efficacy, holds the potential to more rapidly and effectively achieve LDL-C targets in a larger proportion of very high-risk cardiovascular patients. [ABSTRACT FROM AUTHOR]

Simple Summary: This review explores how common sleep disorders, such as insomnia and sleep apnoea, can affect heart health, particularly by increasing the risk of a heart condition called atrial fibrillation (AF). Sleep is vital for overall health, and disruptions in sleep can lead to significant health issues. Insomnia and sleep apnoea are widespread problems that affect millions of people worldwide. This paper examines how these sleep issues might cause changes in the body that lead to heart problems, such as inflammation and stress. The review also discusses how treating sleep disorders, especially with therapies such as continuous positive airway pressure for sleep apnoea, can help reduce the risk of developing AF and improve overall heart health. These conclusions are important because they suggest that addressing sleep disorders could be a key part of preventing and managing heart conditions, ultimately helping to improve people's quality of life and reduce the burden of heart disease on society. Sleep is a complex biobehavioural process essential for overall health, with various dimensions including duration, continuity, timing, and satisfaction. This study investigated the intricate relationships between common sleep disorders such as insomnia and obstructive sleep apnoea (OSA) and their impact on atrial fibrillation (AF), a prevalent arrhythmia with significant health implications. Using a comprehensive review of the current literature, this study examined the pathophysiological mechanisms linking sleep disorders to cardiovascular risks, focusing on autonomic nervous system disturbances, inflammation, and oxidative stress associated with OSA. These findings indicate that sleep disorders significantly elevate the risk of AF through mechanisms such as increased sympathetic activity and structural cardiac remodelling. Additionally, this study highlights the potential benefits of treating sleep disorders, particularly with continuous positive airway pressure (CPAP) therapy, in reducing AF recurrence and improving cardiovascular outcomes. This conclusion emphasises the importance of integrated therapeutic approaches that address both sleep disorders and AF to enhance patient outcomes and quality of life. Future research should explore these connections to develop more effective and holistic treatment strategies. [ABSTRACT FROM AUTHOR]

The CA.ME.LI.A (CArdiovascular risks, MEtabolic syndrome, LIver and Autoimmune disease) epidemiological study was conducted in Abbiategrasso (Milan, Italy) to identify risk factors for metabolic and cardiovascular disease in an apparently healthy population of northern Italy. The population (n = 2,545, 1,251 men, 1,254 women) was stratified according to body mass index [normal body weight (NBW): <25 kg/m2; overweight-obese (OWO): ≥25 kg/m2] and according to fasting blood glucose [normal fasting glucose: <100 mg/dL; impaired fasting glucose (IFG): 100–125 mg/dL; diabetes mellitus (DM): ≥126 mg/dL]. The incidence of cardiovascular (CV) events and overall mortality were studied by the Kaplan–Meier method using the log rank test. Univariate analysis was conducted with time-dependent Cox models. During the 7-yr follow-up period, 80 deaths and 149 CV events occurred. IFG [hazard ratio (HR): 2.81; confidence interval (CI): 1.37–5.77; P = 0.005], DM (HR: 4.88; CI: 1.47–16; P = 0.010), or OWO (HR: 2.78; CI:1.68–4.59; P < 0.001) all produced significant increases in CV events and deaths. In the combination IFG/OWO (HR: 5.51; CI: 3.34–9.08; P < 0.001), there was an apparent additive effect of the two conditions, whereas in the combination DM/OWO (HR: 12.71; CI: 7.48–22; P < 0.001), there was an apparent multiplicative effect on the risk for CV events and deaths. In males, the DM/NBW group had a higher incidence of cardiovascular events and deaths than the IFG/OWO group. In contrast, in females, the IFG/OWO group had a higher incidence of cardiovascular events and deaths than the DM/NBW group. In women, there was a greater incidence of CV events in the IFG/OWO group (HR: 6.23; CI: 2.88–13; P < 0.001) than in men in the same group (HR: 4.27; CI: 2.15–8.47; P < 0.001). Consistent with these data, also all-cause mortality was progressively increased by IFG/DM and OWO, with an apparently exponential effect in the combination DM/OWO (HR: 11.78; CI: 6.11–23; P < 0.001). IFG/DM and OWO, alone or in combination, had major effects in increasing mortality for all causes and CV events. The relative contributions of hyperglycemia and overweight/obesity on cardiovascular events and deaths were apparently, to a certain extent, sex dependent. Females were more affected by overweight/obesity either alone or combined with IFG, as compared with males. NEW & NOTEWORTHY: For the first time, the combined effects of glucose tolerance and BMI have been investigated in an apparently healthy large population sample of a city in the north of Italy. We found that there are synergistic effects of glucose levels with BMI to increase not only cardiovascular events and deaths but also cancer-related deaths and all-cause mortality. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) has become the predominant chronic liver disease globally in recent years, mostly due to the rise in obesity and metabolic syndrome (MS). Non-high-density lipoprotein cholesterol (non-HDL-c) and the ratio of non-HDL-c to HDL-c are emerging as significant indicators for cardiovascular disease risk, especially in patients with metabolic disorders. Method: This observational and record-based study focuses on lipid profile estimations using routine fasting samples billed during March 2022. All samples processed on the Vitros 5.1 FS for lipid profile between March 1st and March 31st, 2022, were included. The study variables were fasting total cholesterol (TC), fasting HDL, fasting LDL, and fasting triglycerides (TG). Inclusion criteria included all samples assayed, while exclusion criteria excluded hemolyzed samples and non-fasting samples. Blood samples, approximately 3ml, were collected after an overnight fasting period of 8-12 hours. Lipid profile estimations were conducted using the Vitros 5.1 FS, employing dry chemistry methods. Result: Descriptive statistics showed that the mean total cholesterol (TC) was 196.68 mg/dL, HDL was 43.16 mg/dL, and non-HDL was 153.52 mg/dL. The CHOL/HDL ratio had a mean of 4.77. A strong positive correlation (r = 0.815, p = 0.001) was observed between non-HDL cholesterol and the CHOL/HDL ratio. Conclusion: The study concludes that lipid profiles should include both non-HDL cholesterol and the cholesterol to HDL ratio. These parameters, when considered alone and in combination, provide a more accurate marker for predicting cardiovascular risk and are highly associated. [ABSTRACT FROM AUTHOR]

In India, NCDs are responsible for 60% of deaths, with cardiovascular incidents being more prevalent in rural areas.1 Advances in the understanding of cardiac autonomic functioning have led to more accessible and effective strategies for preventing and managing major adverse cardiac events (MACE), even with minimal setup. Hospital based prospective observational study of 150 sample size was carried out on adult subjects over the age 20 years reported to Department of Cardiology, Gandhi Medical College, Bhopal from August 2022 to December 2023. MACE risk was assessed by Framingham risk score in all subjects and correlated with Cardiac Autonomic function testing. Among 150 subjects, 40% were diagnosed with Early CAN, 21.33% with Definite CAN, and 2% with Severe CAN based on Ewing's criteria. Regarding MACE risk, 37.33% were at very high risk, 19.33% at high risk, 15.3% at moderate risk, and 28% at mild risk. Diabetic subjects had early and definite CAN at 40.63% each. Hypertensives primarily had early CAN (21.33%), while smokers had a high rate of Definite CAN (43.75%). A significant positive correlation (R=0.2959, p=0.000237) was found between Mean CAN scores and Mean FRS. Weak positive correlations were observed in some cardiac autonomic function tests (lying to standing up, Valsalva) with FRS, while others showed weak negative correlations. Significant correlations (p<0.05) were noted between CAN scores and FRS parameters like age, diabetes, and smoking. Individual FRS parameters also had a highly significant correlation with CAFTs (P<0.0001). Hence, we conclude that this prospective study, established a positive correlation between Cardiac Autonomic Function Testing (CAFT) and Cardiovascular Risk in adults. Thus, CAFT could be used as a cost-effective and accessible test for even healthcare centers with limited resources for early identification and screening of MACE. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive impairment, marked by a decline in memory and attention, is frequently underdiagnosed, complicating effective management. Cardiovascular risk factors (CVR) and anticholinergic burden (ACB) are significant contributors to dementia risk, with ACB often stemming from medications prescribed for neuropsychiatric disorders. This study evaluates cognitive profiles through three brief cognitive tests, analyzing the impact of CVR and ACB presence. Methods: This cross-sectional study was performed between 2019 and 2023 in community pharmacies and an outpatient clinic in Valencia, Spain. Eligible participants were patients with subjective memory complaints 50 years or older with clinical records of cardiovascular factors. Patients with conflicting information regarding diabetes diagnosis or not taking concomitant medications were excluded. Three brief cognitive tests (Memory Impairment Screening (MIS), Semantic Verbal Fluency Test, and SPMSQ) were assessed. CVR was calculated using the European SCORE2 table, and ACB was assessed using the CALS scale. Results: Among 172 patients with memory complaints and CVR factors, 60% failed at least one cognitive test. These patients were on significantly more medications and had higher blood pressure and HbA1c levels. An increase in CVR and ACB was associated with more failed tests. Additionally, elevated SCORE2 scores were associated with a greater failure rate on the MIS test, while patients with elevated ACB more frequently failed the SPMSQ test. Conclusions: Selecting an adequate brief cognitive test according to patients' characteristics offers an opportunity to screen patients who are probably cognitively impaired. Whereas the MIS test may be helpful for patients with cardiovascular risk, SPMSQ stands out among patients with significant ACB. [ABSTRACT FROM AUTHOR]

Background: Increased cardiovascular risk has been described in individuals with adrenal incidentalomas. The aim of the present study is to assess the effect of remnant cholesterol (RC) on the cardiovascular risk and mortality of patients with adrenal incidentalomas. Methods: A retrospective cohort study was conducted with patients with adrenal incidentalomas between 2001 and 2024. One hundred thirty-seven patients (mean age of 61.2 ± 11.5 years; 56.6% women) with non-functioning adrenal incidentalomas and with mild autonomous cortisol secretion (MACS) (cortisol post-dexamethasone suppression test ≥1.8 µg/mL) were included. The patients were divided into two groups using 30 mg/dL as the cut-off for RC. Logistic regression models were used to study the impact of RC on major adverse cardiovascular events and mortality (MACEs). Results: Patients with RC ≥ 30 mg/dL exhibited a higher prevalence of type 2 diabetes mellitus (T2D) (p < 0.001), lower HDL-C (p < 0.001) and LDL-C (p = 0.025) levels, a higher frequency of treatment with statins (p = 0.032), and a higher rate of non-fatal major cardiovascular events (p = 0.038) and MACEs (p = 0.038). Patients with MACS showed no differences in RC or complications during the follow-up. The relative risk of high RC was 2.65 (1.04–6.77) for cardiovascular events and 2.27 (1.05–4.92) for MACEs, with p < 0.05 in both cases. The only variables independently affecting MACEs were age ([odds ratio] OR = 1.13 [p = 0.004]), female sex (OR = 0.20; p = 0.016), LDL-C (OR = 1.02; p = 0.029), and RC (OR = 1.06; p = 0.014). T2D and HDL-C were not independently associated with MACEs. Conclusions: RC ≥30 mg/dL in patients with adrenal incidentalomas was associated with a higher prevalence of T2D, lower HDL-C levels, and a higher risk of MACEs. MACS was not associated with RC or MACEs during the follow-up. [ABSTRACT FROM AUTHOR]

The triad formed by thyroid dysfunction, metabolic syndrome (MetS), and cardiovascular (CV) risk forms a network with many connections that aggravates health outcomes. Thyroid hormones (THs) play an important role in glucose and lipid metabolism and hemodynamic regulation at the molecular level. It is noteworthy that a bidirectional association between THs and MetS and their components likely exists as MetS leads to thyroid dysfunction, whereas thyroid alterations may cause a higher incidence of MetS. Thyroid dysfunction increases insulin resistance, the circulating levels of lipids, in particular LDL-C, VLDL-C, and triglycerides, and induces endothelial dysfunction. Furthermore, THs are important regulators of both white and brown adipose tissue. Moreover, the pathophysiological relationship between MetS and TH dysfunction is made even tighter considering that these conditions are usually associated with inflammatory activation and increased oxidative stress. Therefore, the role of THs takes place starting from the molecular level, then manifesting itself at the clinical level, through an increased risk of CV events in the general population as well as in patients with heart failure or acute myocardial infarction. Thus, MetS is frequently associated with thyroid dysfunction, which supports the need to assess thyroid function in this group, and when clinically indicated, to correct it to maintain euthyroidism. However, there are still several critical points to be further investigated both at the molecular and clinical level, in particular considering the need to treat subclinical dysthyroidism in MetS patients. [ABSTRACT FROM AUTHOR]

Introduction: Uremic patients exhibit remarkably increased rates of mortality and cardiovascular (CV) events, but risk prediction in this setting remains difficult. Systemic mitochondrial dysfunction is pervasive in end-stage kidney disease and may contribute to CV complications. We tested the clinical significance of circulating MOTS-c, a small mitochondrial-derived peptide, as a biomarker for improving mortality and CV risk prediction in hemodialysis (HD) patients. Methods: We conducted a prospective, observational, multicenter study on 94 prevalent HD patients. The study endpoint was a composite of all-cause mortality and non-fatal CV events. The diagnostic and prognostic capacities of predictive models based on cohort-related risk factors were tested before and after the inclusion of MOTS-c. Results: MOTS-c levels were higher in HD patients than in controls (p < 0.001) and even more elevated (p = 0.01) in the 53 individuals experiencing the combined endpoint during follow-up (median duration: 26.5 months). MOTS-c was independently associated with the endpoint at either multivariate logistic (OR 1.020; 95% CI: 1.011–1.109; p = 0.03) or Cox regression analyses (HR 1.004; 95% CI: 1.000–1.025; p = 0.05) and the addition of this biomarker to prognostic models including the other cohort-related risk predictors (age, left ventricular mass, evidence of diastolic dysfunction, diabetes, pulse pressure) significantly improved the calibration, risk variability explanation, discrimination (receiver operating characteristic area under the curve from 0.727 to 0.743; C-index from 0.658 to 0.700), and particularly, the overall reclassification capacity (NRI 15.87%; p = 0.01). Conclusions: In HD patients, the mitochondrial-derived peptide MOTS-c may impart significant information to refine CV risk prediction, beyond cohort-related risk factors. Future investigations are needed to generalize these findings in larger and more heterogeneous cohorts. [ABSTRACT FROM AUTHOR]

Introduction: Trimethylamine N-oxide (TMAO) is a gut bacteria-dependent metabolite associated with poor cardiovascular health. Exercise is a known cardioprotective activity but the impact of an acute bout of exercise on TMAO production is unknown. Objectives/Methods: This study assessed choline-derived production of TMAO following a single bout of intermittent exercise in a young, healthy cohort. Results: Choline supplemented after either exercise or a time-matched resting period demonstrated a similar increase in circulating TMAO across an 8-hour period. Conclusion: This suggests that a single bout of intermittent exercise does not alter gut microbial metabolic behaviour and thus does not provide additional cardioprotective benefits related to blood levels of TMAO. [ABSTRACT FROM AUTHOR]

Background: Allergic diseases begin early in life and are often chronic, thus creating an inflammatory environment that may precede or exacerbate other pathologies. In this regard, allergy has been associated to metabolic disorders and with a higher risk of cardiovascular disease, but the underlying mechanisms remain incompletely understood. Methods: We used a murine model of allergy and atherosclerosis, different diets and sensitization methods, and cell‐depleting strategies to ascertain the contribution of acute and late phase inflammation to dyslipidemia. Untargeted lipidomic analyses were applied to define the lipid fingerprint of allergic inflammation at different phases of allergic pathology. Expression of genes related to lipid metabolism was assessed in liver and adipose tissue at different times post‐allergen challenge. Also, changes in serum triglycerides (TGs) were evaluated in a group of 59 patients ≥14 days after the onset of an allergic reaction. Results: We found that allergic inflammation induces a unique lipid signature that is characterized by increased serum TGs and changes in the expression of genes related to lipid metabolism in liver and adipose tissue. Alterations in blood TGs following an allergic reaction are independent of T‐cell‐driven late phase inflammation. On the contrary, the IgG‐mediated alternative pathway of anaphylaxis is sufficient to induce a TG increase and a unique lipid profile. Lastly, we demonstrated an increase in serum TGs in 59 patients after undergoing an allergic reaction. Conclusion: Overall, this study reveals that IgG‐mediated allergic inflammation regulates lipid metabolism. [ABSTRACT FROM AUTHOR]

Background: Obesity is a prevalent health issue associated with an increased risk of cardiovascular diseases. While obesity's link to various cardiovascular conditions is well-documented, its specific impact on global longitudinal strain (GLS) requires further investigation. This study aims to explore the relationship between obesity and GLS in an adult population. Materials and Methods: This cross-sectional study included 91 adult participants, categorized into obese (n=59) and non-obese (n=32) groups based on body mass index (BMI). GLS was measured using speckle-tracking echocardiography. Chi-square tests and odds ratios (OR) were used to assess the association between obesity and abnormal GLS. Results: Among the non-obese group, 25.0% had abnormal GLS compared to 20.3% in the obese group. The chi-square test indicated no significant difference in the prevalence of abnormal GLS between the groups (p = 0.60). The odds ratio for abnormal GLS in obese versus non-obese participants was 1.3 (95% CI: 0.4-3.6), indicating no significant association. Conclusion: The study found no significant association between obesity and abnormal GLS, suggesting that BMI alone may not be a reliable predictor of subclinical myocardial dysfunction. These findings highlight the need for a comprehensive approach to cardiovascular risk assessment that includes multiple factors beyond BMI. [ABSTRACT FROM AUTHOR]

Methamphetamine (METH) is a highly addictive psychostimulant that not only impacts the central nervous system but also poses significant risks to metabolic and cardiovascular health. This study investigates the chronic effects of METH on the lipid profile and cardiovascular risk in Wistar rats using appropriate standard method. Data obtained show that methamphetamine induced significant weight loss in the high dose group (from 0.46 to 0.39 g/cm²). The lipid profile result (table 2) indicated reduction in cholesterol (CHOL), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels with higher doses, while triglycerides (TG) increased. The findings revealed that chronic METH intake led to a dose-dependent reduction in body mass index (BMI) and significant alterations in lipid parameters. These suggest that METH alters lipid metabolism, potentially contributing to increased cardiovascular risk in chronic users. [ABSTRACT FROM AUTHOR]

To investigate the association between cardiovascular risk estimated using the Framingham Risk Score (FRS) and carotid stiffening determined using ultrafast pulse wave velocity (ufPWV) measurements in apparently healthy individuals. We enrolled 1034 apparently healthy participants without known cardiovascular disease who underwent ufPWV measurements. Clinical and laboratory findings, carotid intima–media thickness (cIMT), pulse wave velocity at the beginning of systole (PWV-BS), and pulse wave velocity at the end of systole (PWV-ES) were assessed. In FRS assessments based on major cardiovascular risk factors (CVRFs), participants were assigned into three risk categories: low risk (<10%, n = 679), intermediate risk (10–20%, n = 191), and high risk (>20%, n = 164); the low-risk category was further subdivided into three subcategories: < 1% (n = 58), 1%− 5% (n = 374) and > 5% (n = 247). Multivariate logistic regression analyses with crude and adjusted odds ratios (ORs) were used to evaluate the association of carotid stiffening and FRS-based risk stratification. Carotid stiffening indicated by PWV-BS and PWV-ES differed notably between the FRS-estimated low-risk vs. intermediate-risk and high-risk categories, but only PWV-ES differed notably among the low-risk subcategories (all p < 0.010), and correlated notably with the FRS-estimated risk most obviously in low-risk participants (r = 0.517). In participants with cIMT < 0.050 cm, only PWV-ES differed significantly among the FRS-estimated risk categories (all p < 0.001). Increased PWV-BS (adjusted OR: 1.49; p = 0.003) and PWV-ES (adjusted OR: 1.29; p = 0.007) were both associated with FRS categories independent of conventional CVRFs in low- vs. intermediate-risk categories, but not in low- vs. high-risk categories (all p > 0.050). In vivo imaging of carotid stiffening by ufPWV measurements is independently linked to FRS categories, and ufPWV indices may help stratify differing levels of cardiovascular risk in apparently healthy young people. Data generated or analyzed during the study are available from the corresponding author by reasonable request. • Carotid stiffening quantified by ufPWV measurements differed notably among FRS-estimated risk categories and low-risk subcategories. • ufPWV indices correlated notably with FRS-estimated risk and major CVRFs. • PWV-ES increased steeply with higher FRS categories, even with normal cIMT. • ufPWV indices were associated with cardiovascular risk stratification independently in low- vs. intermediate-risk populations. • ufPWV may be a promising quantitative predictor for cardiovascular risk stratification in apparently healthy young people. [ABSTRACT FROM AUTHOR]

BACKGROUND Myostatin is a protein compound, structurally related to the transforming growth factor-beta protein, which plays a pivotal role in regulating muscle growth and extracellular matrix production. It exerts both profibrotic and antihypertrophic effects on vascular smooth muscle cells. Aim of the study was to explore the potential association between serum myostatin levels (sMSTN) and carotid-femoral pulse wave velocity (cf-PWV), carotid-radial pulse wave velocity (cr-PWV), and their ratio (PWVr), in a cohort of healthy adolescents. METHODS A cohort of 128 healthy subjects (mean age 17 ± 2 years, 59% male) was randomly selected from participants to the MACISTE (Metabolic And Cardiovascular Investigation at School, TErni) study. sMSTN was assessed utilizing an enzyme-linked immunosorbent assay. PWVs were measured in the supine position using high-fidelity applanation tonometry. RESULTS The mean cf-PWV was 5.1 ± 0.9 m/s, cr-PWV was 6.9 ± 0.9 m/s, and PWVr was 0.75 ± 0.12. PWVr exhibited a linear increase across increasing quartiles of sMSTN (0.71 ± 0.1, 0.74 ± 0.1, 0.7 ± 0.1, 0.77 ± 0.1, P for trend = 0.03), whereas the association between sMSTN and each single component of PWVr (cf-PWV, cr-PWV) did not attain statistical significance. Quartiles of sMSTN displayed a positive trend with serum HDL-cholesterol (P  = 0.01) and a negative one with LDL-cholesterol (P  = 0.01). In a multivariate linear model, the association between PWVr and sMSTN was independent of SBP values, age, sex, heart rate, BMI, HDL-cholesterol, and HOMA Index CONCLUSIONS In healthy adolescents, sMSTN showed independent associations with PWVr, a measure of central-to-peripheral arterial stiffness gradient. sMSTN may exert differential effects on the structural and functional properties of the arterial wall. [ABSTRACT FROM AUTHOR]