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Despite recent efforts to address health disparities regarding social determinants of health (SDOH), the intersection between SDOH and cardiovascular health (CVH) outcomes in sexual minority (SM) individuals remain largely underexplored. This study sought to investigate associations between SDOH profile and CVH and mortality outcomes among SM individuals in the United States. All participants aged ≥18 years surveyed in the 2013 to 2017 National Health Interview Survey were included, except those with missing data on SM status, any CVH or SDOH domain, or any other covariate. SM status was self-reported and categorized as lesbian/gay, bisexual, or uncertain. Participants' SDOH profile was quantified using a 6-domain (economic stability, neighborhood/physical environment/social cohesion, community and social context, food, education, and health care system), 38-item score, with higher scores indicating greater social deprivation. CVH was adapted from the American Heart Association's Life's Essential 8 framework. Because detailed dietary data were unavailable, a 7-item (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical inactivity, inadequate sleep, and obesity) CVH score was used, with higher scores indicating worse CVH. Additionally, cardiovascular mortality was ascertained through the National Death Index using death certificate information. The study sample consisted of 57,182 participants, representing a population of 82,826,690 persons. A worse composite SDOH score was associated with a worse CVH score in both heterosexual (adjusted rate ratio: 1.14; 95% CI: 1.13-1.15; P < 0.001) and SM individuals (adjusted rate ratio: 1.16; 95% CI: 1.12-1.20; P < 0.001), with associations appearing to be potentially stronger in the latter (P interaction = 0.042). Subgroup analysis demonstrated consistent associations among gay/lesbian individuals and bisexual individuals, but not in those with other or uncertain sexual orientations. Further exploratory analysis showed that a worse composite SDOH score was significantly associated with higher risk of cardiovascular mortality in both heterosexual (adjusted HR: 1.17; 95% CI: 1.06-1.28; P = 0.002) and SM individuals (adjusted HR: 2.25; 95% CI: 1.24-4.08; P = 0.008), with associations being significantly stronger in the latter (P interaction = 0.006). An unfavorable SDOH profile was associated with worse CVH scores and higher cardiovascular mortality risk among SM individuals in the United States compared to their heterosexual counterparts. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: Infertility is not only a reproductive issue but is also closely linked to cardiovascular health and other factors. Life's Crucial 9 (LC9) is a set of lifestyle guidelines aimed at improving cardiovascular health, yet its potential association with infertility remains underexplored. This study aims to investigate the relationship between LC9 and infertility, providing new insights and strategies for the prevention and management of infertility. Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. Multivariate logistic regression and weighted quantile sum (WQS) regressions were employed to investigate the association between LC9 and infertility. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between LC9 and infertility. Interaction analyses were conducted on subgroups to validate the findings. Results: There was a significant negative association between LC9 and infertility. After adjusting for covariates, for every 10-point increase in LC9, there was a 35% decrease in the prevalence of infertility (P < 0.001). This negative correlation persisted when LC9 was divided into quartiles. Moreover, as LC9 increased, there was a trend towards lower infertility prevalence (P for trend < 0.001). WQS analyses showed consistent associations (OR=0.27, 95%CI: 0.14, 0.53), with sleep health score, psychological health score, and Body mass index score as significant factors. The dose-response curve indicated a linear association between LC9 and infertility, with higher LC9 associated with lower infertility risk. Conclusion: The results of this study show a strong negative correlation between LC9 and the prevalence of infertility. Clinically, these findings offer hope for infertility patients, suggesting that adherence to a higher LC9 score significantly reduces the risk of infertility. This will provide a new avenue for infertility prevention and management, offering hope and potential relief to infertile patients. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between Life's Essential 8 (LE8), a measure of cardiovascular health (CVH), and the risk of gallstones in adult Americans. We analyzed data from 5,024 participants aged 20 and older, using information from the 2017–2020 National Health and Nutrition Examination Survey. Gallstone presence was determined via a standard questionnaire. LE8 scores, representing four health behaviors (sleep, tobacco/nicotine exposure, physical activity, and diet) and four health factors (body mass index, non-high-density lipoprotein cholesterol, blood glucose, and blood pressure), were categorized into low, moderate, and high CVH groups. Weighted logistic regression, restricted cubic splines (RCS), and stratified analyses were used to assess the association between LE8 and gallstones. Of the 5,024 participants, 543 (11.22%) had gallstones. In fully adjusted models, participants with high CVH (LE8 ≥ 80) had a 59% lower risk of gallstones compared to those with low CVH (LE8 < 50) (OR: 0.41, 95% CI: 0.23–0.72, P = 0.010). RCS analyses suggested a nonlinear relationship between LE8 and gallstones. Stratified analysis showed a stronger association in participants under 65 (OR: 0.26, 95% CI: 0.15–0.44), females (OR: 0.44, 95% CI: 0.24–0.81), those with higher education (OR: 0.39, 95% CI: 0.19–0.78), non-white individuals (OR: 0.28, 95% CI: 0.13–0.60), and married participants (OR: 0.40, 95% CI: 0.20–0.80). Higher CVH, as measured by LE8, is associated with a lower risk of gallstones among adult Americans. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review summarizes recent evidence linking experiences of discrimination and anticipated discrimination with cardiovascular health outcomes. Recent Findings: Experiences of discrimination were consistently associated with increased risk of nicotine exposure, poor sleep health, obesity, diabetes, hypertension, and subclinical cardiovascular disease. Evidence is mixed for cardiovascular disease diagnoses and cardiovascular mortality. Although research is limited, anticipated discrimination is an independent risk factor for poor sleep health and subclinical cardiovascular disease. Key methodological limitations included the limited use of gold-standard objective measures of health behaviors and well-validated self-report measures, inadequate consideration of intersectionality, and lack of robust examinations of psychological, behavioral, and physiological mechanisms linking discrimination with cardiovascular health outcomes. Summary: There is substantial evidence linking experiences of discrimination with cardiovascular outcomes. Yet, before translating these findings into clinical practice, more rigorous studies are needed to address methodological limitations and uncover mechanisms by which discrimination influences cardiovascular health. There is a need for studies to inform the development of evidence-based interventions focused on reducing the influence of discrimination-related stressors on cardiovascular health outcomes. Findings have important implications for future work to advance cardiovascular health equity. [ABSTRACT FROM AUTHOR]

Atherosclerosis, a condition characterized by the accumulation of lipids and a culprit behind cardiovascular events, has long been studied. However, in recent years, there has been an increase in interest in its initiation, with researchers shifting focus from traditional pathways involving the vascular infiltration of oxidized lipids and towards the novel presence of chronic inflammatory pathways. The accumulation of pro-inflammatory cytokines, in combination with the activation of transcription factors, creates a positive feedback loop that drives the creation and progression of atherosclerosis. From the upregulation of the nod-like receptor protein 3 (NLRP3) inflammasome and the Notch and Wnt pathways to the increased expression of VEGF-A and the downregulation of connexins Cx32, Cx37, and Cx40, these processes contribute further to endothelial dysfunction and plaque formation. Herein, we aim to provide insight into the molecular pathways and mechanisms implicated in the initiation and progression of atherosclerotic plaques, and to review the risk factors associated with their development. [ABSTRACT FROM AUTHOR]

Background There have been many studies of the association between testosterone and cardiovascular disease (CVD). However, limited research has examined the association between testosterone and Life's Essential 8 (LE8), a recently updated algorithm for assessing cardiovascular health (CVH). Objectives This study aims to investigate the association between serum total testosterone (TT) levels and LE8 scores—where higher LE8 scores indicate better CVH—among adult males in the United States. Method Data from 3308 adult males were extracted from the National Health and Nutrition Examination Survey conducted between 2013 and 2016. Weighted univariate and multivariate linear regression models [β and 95% confidence intervals (CIs)] and logistic regression models [odds ratios (ORs) and 95% CIs] were used to explore the association between testosterone and LE8 and high CVH risk. Additionally, a smoothed curve fit (penalized spline method) and generalized additive model regression were applied to further explore these relationships. Outcomes LE8 includes 4 health behaviors (nicotine exposure, diet, physical activity, and sleep duration) and 4 health factors (body mass index, non–high-density lipoprotein cholesterol, blood pressure, and blood glucose). Results Serum TT levels were strongly associated with LE8 scores after adjusting for all confounders (continuous: β = 2.75, 95% CI: 1.92, 3.57, P  < .0001; quartiles: Q4 vs Q1: β = 3.89, 95% CI: 2.78, 5.01, P  < .0001). Similarly, high levels of TT were associated with a significantly lower CVH risk (OR = 0.59, 95% CI: 0.49, 0.73, P  < .001). Compared to low TT levels, normal TT levels significantly reduced the risk of CVH (OR = 0.51, 95% CI: 0.38, 0.69, P  < .001). Smoothed curve fitting showed a positive linear correlation between TT levels and LE8 scores, as well as a consistent linear negative correlation with CVH risk. Clinical Implications These findings highlight the importance of endogenous TT levels in promoting CVH and provide new insights into factors influencing CVH. Strengths and Limitations This study is the first to investigate the association between serum TT level and LE8 scores as well as LE8-assessed CVH among adult males. However, the observational nature of this study precludes any assessment of causality. Conclusions This study demonstrates a robust positive association between serum TT levels and LE8 scores in a nationally representative sample of adult men in the United States. [ABSTRACT FROM AUTHOR]

AbstractThe menopause experience is unique to people with ovaries who attain an age at which functioning follicles are depleted. Unlike male reproductive aging, menopause is accompanied by a definable reproductive milestone in that menstrual periods cease and the failure of follicle growth results in a large drop in circulating estrogen and no further ovarian production of progesterone. While the focus on menopause has largely been centered on this absence of hormone production, the most dynamic changes in symptoms and health markers begin before the final menstrual period, and merit attention. Vasomotor symptoms, the most common symptom of menopause and the primary symptom that drives women to seek treatment, peak in frequency and prevalence in the late menopause transition, when women are still having menstrual periods. Body composition and adverse lipoprotein and lipid changes also worsen most acutely in the late transition, and then assume a slower, age-related trajectory of change. Multiple processes that worsen across the transition restabilize after it is over. The notion that the menopause transition is an adaptive process for women has scientific merit and suggests that facilitating this adaptation and recognizing its implications may represent the next phase of progress in the field. [ABSTRACT FROM AUTHOR]

Objectives: Life's essential 8 (LE8) is an emerging approach for accessing and quantifying cardiovascular health (CVH), but the effect on Parkinson's disease (PD) is still unclear. This study aimed to elucidate the association between LE8 metrics and PD in the US adults. Methods: Data of 26,975 participants were extracted from the last 7 National Health and Nutrition Examination Survey (NHANES) cycles (2005–2018). The LE8 metrics were calculated according to the American Heart Association criterion, and participants were divided into 3 groups using tertile range. Multivariate logistic regression models were constructed to explore the association between LE8 metrics and PD. Sensitivity analysis was conducted to verify robustness. A nonlinear linkage was evaluated via restricted cubic spline (RCS). The stability of this effect was validated by subgroup analysis and interaction test. Results: A total of 26,975 eligible participants (including 271 PD cases and 26,704 non-PD cases) were included in this study. The multivariate logistic regression models revealed a reverse association of continuous LE8 metrics with PD with ORs of 0.97 (unadjusted model [95% CI: 0.96–0.98, P < 0.01], partially adjusted model [95% CI: 0.97–0.98, P < 0.01], fully adjusted model [95% CI: 0.95–0.98, P < 0.01]). Compared to those of low group, the ORs for high group were 0.37 (95% CI: 0.27–0.50, P < 0.01) in unadjusted model, 0.51 (95% CI: 0.36–0.72, P < 0.01) in partially adjusted model, and 0.51 (95% CI: 0.32–0.81, P < 0.01) in fully adjusted model. The sensitivity analysis ensured the robustness of the observed LE8-PD association. A nonlinear relationship (Pnonlinearity < 0.01) was observed via RCS analysis. The subgroup analysis showed that participants'gender might impact the strength of LE8 metrics-PD association (Pinteraction = 0.029). Conclusions: CVH, as delineated by LE8 metrics, was reversely associated with PD in the dose–response pattern, more pronounced in female compared to male. These findings highlight the potential of the LE8 metrics to guide targeted strategies for addressing gender-based CVH disparities, offering beneficial insights for the tertiary prevention of PD. [ABSTRACT FROM AUTHOR]

Objectives: We investigate whether volunteering is associated with a reduced risk of first heart attack in later life and whether purpose in life moderates this relationship. Methods: Cox proportional hazards were used to examine seven waves of data (2006–2018) from the Health and Retirement Study–a nationally representative survey of adults 50 years and older (N = 5,079). Results: Volunteering a moderate number of hours was associated with a 46% lower risk of heart attack compared to non-volunteers. The association between high time-commitment volunteering and heart attack risk was contingent on level of purpose in life: compared to non-volunteers, people with high purpose in life who volunteered 100 + hours had the lowest risk of heart attack. Discussion: Meaningful volunteer activities may be one way for older adults to reduce their risk of heart attack. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate associations between pre-pregnancy maternal obesity and adolescent blood pressures (BPs) among children born extremely preterm. Methods: This longitudinal observational cohort study included participants in the multicenter Extremely Low Gestational Age Newborn (ELGAN) study, born before 28 weeks of gestation, recruited at birth between 2002 and 2004, and followed prospectively through late adolescence. Between 2015 and 2022, three oscillometric BPs were obtained from participants (mean age 17.8 years). We used linear regression modeling to evaluate the association between maternal self-reported pre-pregnancy body mass index (BMI) and offspring adolescent systolic BP (SBP). In secondary analyses, we evaluated the association between maternal pre-pregnancy and offspring preadolescent (10-year-old) BMI and between offspring preadolescent BMI and adolescent SBP. Results: The 100 (24%) participants born to a mother with a history of pre-pregnancy obesity (BMI ≥ 30) had a greater mean SBP of 120.5 (± 14.3) mmHg compared to the 324 (76%) of adolescents born to mothers without pre-pregnancy obesity (SBP 115.6 (± 12.0) mmHg). Pre-pregnancy obesity was associated with higher offspring BMI (aβ 10.8, 95% CI 2.3, 19.2), and higher offspring BMI was associated with higher adolescent SBP (aβ 0.12, 95% CI 0.09,0.16). Conclusions: For ELGANs, higher maternal pre-pregnancy BMI was associated with higher adolescent SBP. Findings from secondary analyses suggest potential mediation through preadolescent BMI. Future research directions include multi-level interventions to reduce maternal pre-pregnancy obesity, followed by offspring obesity prevention interventions as a way of reducing intergenerational cardiovascular disease in high-risk infants born extremely preterm. [ABSTRACT FROM AUTHOR]

An important area of health is health promotion. A healthy lifestyle supports health improvement and early prevention of chronic diseases. Stimulation of the body by cold water swimming and swimming in a swimming pool can lead to adaptive changes beneficial for the human cardiovascular system. Within the winter swimming season of 2023/2024, for a period of 5 months, from November to March, once a week, study participants (n = 30; n = 15 females and n = 15 males) from the Krakow Society of Winter Swimmers 'Kaloryfer' in Krakow (Poland) practiced winter swimming in cold water (4–5 °C) and swam in the sports pool of the University of Physical Culture in Krakow in water at a temperature of 28 °C. After a full season of winter swimming and swimming pool sessions, both males and females exhibited a tendency towards lower erythrocyte (p = 0.002), leukocyte (p < 0.001), and platelet counts (p < 0.001), as well as an increase in blood plasma viscosity (within normal limits) (p = 0.001), without any changes in blood aggregation or fibrinogen indicators. The remaining morphological indicators and the elongation index demonstrated only limited variation. Winter swimming induces positive changes in blood morphology and rheology. [ABSTRACT FROM AUTHOR]

Coconut oil (CNO) is often characterized as an "artery-clogging fat" because it is a predominantly saturated fat that ostensibly raises total cholesterol (TChol) and LDL cholesterol (LDL-C). Whereas previous analyses assessed CNO based on the relative effects on lipid parameters against other fats and oils, this analysis focuses on the effects of CNO itself. Here, we review the literature on CNO and analyze 984 lipid profile data sets from 26 CNO studies conducted over the past 40 years. This analysis shows considerable heterogeneity among CNO studies regarding participant selection, the amount consumed, and the study duration. The analysis reveals that, overall, CNO consumption gives variable TChol and LDL-C values, but that the HDL-cholesterol (HDL-C) values increase and triglycerides (TG) decrease. This holistic lipid assessment, together with the consideration of lipid ratios, shows that CNO does not pose a health risk for heart disease. Because the predominantly medium-chain fatty acid profile of CNO is significantly different from that of lard and palm oil, studies using these as reference materials do not apply to CNO. This paper concludes that the recommendation to avoid consuming coconut oil due to the risk of heart disease is not justified. [ABSTRACT FROM AUTHOR]

The role of right ventricular (RV) dysfunction in pulmonary hypertension (PH) has garnered increasing interest in terms of outcomes. This systematic review and meta-analysis evaluated the prognostic utility of three-dimensional echocardiography (3DE) derived right ventricular ejection fraction (RVEF) in PH. A systematic review and meta-analysis were performed using MEDLINE, Embase, and Scopus databases for publications reporting the hazard ratio (HR) of 3DE-derived RVEF in PH patients for the clinical end-points of composite outcome or all-cause mortality. Nine articles totaling 885 subjects were included, among which 67.23% had pulmonary arterial hypertension (PAH), with the remainder having a range of PH etiologies. The mean value of 3DE-derived RVEF was 35.5 ± 9.07% reflecting impaired RV function. The primary endpoint was all-cause mortality in three studies, while the rest of the studies reported composite outcomes. Follow-up duration ranges from 6 to 44 months. From seven publications, the pooled HR by 3DE-derived RVEF was 0.91 (95% CI: 0.85 to 0.97, p = 0.001; heterogeneity: I2 = 62%, p = 0.004). In subgroup analysis, 3DE-derived RVEF was a significant prognostic factor for group 1 PH (HR: 0.90, CI: 0.86–0.94; heterogeneity I2 = 43%, p < 0.0001). From meta-regression analysis, only follow-up duration was found statistically significant with the HR of RVEF in the population (estimate: 0.028, p = 0.026). 3DE-derived RVEF provides important prognostic value in a large population of PH patients, especially for group 1 PH. Further accumulation of evidence is needed to perform a detailed subgroup analysis in each type of PH. [ABSTRACT FROM AUTHOR]

The American Heart Association's (AHA) Life's Essential 8 (LE8) metrics provide a framework for assessing cardiovascular health (CVH). This study evaluates the relationship between CVH levels from LE8 and mortality risk, considering biological aging's role. Using data from the NHANES non-CVD adult population, CVH scores were categorized as low (< 50), moderate (50–79), and high (≥ 80) per AHA guidelines. Cox regression model assessed the impact of CVH levels on all-cause and cardiovascular mortality, while examining four aging indicators as mediators. RCS explored the relationships between CVH scores and mortality risk. The model's performance was evaluated using nine machine learning algorithms, with SHAP analysis on the best model to determine CVH score components' importance. Cox regression showed that all-cause mortality rates decreased by 35% for moderate and 54% for high CVH groups compared to low CVH. The high CVH group had a 59% lower cardiovascular mortality rate. Each unit increase in CVH score reduced all-cause and cardiovascular mortality to 0.98 times. RCS analysis revealed a nonlinear trend between CVH scores and mortality risk. Biological aging indicators significantly mediated the CVH–mortality relationship, with PhenoAge (21.57%) and KDM-Age (20.33%) showing the largest effects. The XGBoost model outperformed others, with SHAP analysis ranking CVH components: physical activity, nicotine, blood pressure, BMI, lipids, healthy eating index, blood glucose, and sleep. Higher CVH levels correlate with reduced all-cause and cardiovascular mortality risk, with biological aging mediating these effects. Adhering to AHA's LE8 metrics is recommended to enhance life expectancy in the non-CVD population. [ABSTRACT FROM AUTHOR]

This study investigated sex differences in indicators of mental health (anxiety, depression) and cardiovascular health (e.g., physical activity levels, heart rate, VO2 max) in a sample of cannabis-using undergraduates. The sample included 209 participants (65% female) who completed two daily diaries for 14 days on their mobile devices; half of whom (n = 100) also wore a Fitbit Charge 4. Females (vs. males) reported significantly more psychological distress at baseline; greater use of cannabis to cope with symptoms of both physical and mental ill-health; and more risks to cardiovascular health. Discriminant function analysis revealed that the variables that significantly distinguished females from males were: 1. Lower VO2 max percentile; 2. Fewer "moderate-to-very active" minutes of physical activity; 3. Higher depression scores plus poorer perceptions of mental health and physical health. Findings from this study suggest that female emerging adults who use cannabis regularly may be uniquely vulnerable to cannabis-related risks. [ABSTRACT FROM AUTHOR]

Several modifiable health factors in Life's Essential 8 (LE8) are linked to nutritional anemia and can assess overall cardiovascular health (CVH). This study explored the associations of CVH measured by LE8 score with nutritional anemia and iron deficiency anemia (IDA), including the mediating role of inflammatory biomarkers. This prospective cohort study included 181,069 participants from UK Biobank. CVH was categorized into low (0–49), medium (50–79), and high (80–100) based on the LE8 score. Weibull regression models were used to quantify the association between CVH and nutritional anemia and IDA. During a median follow-up of 8.6 years, 6749 cases of nutritional anemia occurred, including 92% (6223/6749) IDA cases. After adjusting for covariates, participants with moderate CVH and high CVH had a 44% and 54% lower risk of nutritional anemia (Moderate: hazard ratio [HR] 0.56; 95% confidence interval [CI], 0.51–0.60; High: HR 0.46; 95% CI, 0.41–0.51), and a 46% and 54% lower risk of IDA (Moderate: HR 0.54; 95% CI, 0.50–0.59; High: HR 0.46; 95% CI, 0.41–0.51), respectively, compared to those with low CVH. An L-shaped association was observed between CVH score and both types of anemia. Inflammatory biomarkers explained 22.1% and 21.6% of the associations between CVH and nutritional anemia and IDA, respectively. Higher CVH scores were associated with lower risk of nutritional anemia and IDA, and these associations may be partially mediated by inflammatory biomarkers. These findings emphasize the importance of CVH and inflammation in preventing nutritional anemia. [ABSTRACT FROM AUTHOR]

While the physical health effects of obesity are well-characterized, an emerging branch of research has shown that obesity additionally plays a critical role in one's mental health. Young adults, in a pivotal transition phase in their lives, may be particularly prone to the concurrent effects of obesity and adverse mental health outcomes. The purpose of this review is to comprehensively examine existing data regarding the connection between obesity and two widely validated measures of mental health: psychological distress and depression. The connection between mental health outcomes and obesity is mediated by a complex interplay between biological and sociocultural factors, which is explored in this review with particular focus on younger adults aged 20-39. Further, the impact of several demographic factors including race/ethnicity, gender, and immigration status are examined closely. To our knowledge, this review is one of the first efforts to integrate existing knowledge between obesity and mental health, with particular regard for young adults and the impact of other key sociodemographic characteristics. This review has important implications at the interface of two of the most pressing public health crises in the United States. [ABSTRACT FROM AUTHOR]

A healthy lifestyle plays a key role for maintaining the cardiovascular health (CVH) status and prevent cardiovascular disease occurrence. In fact, a healthy lifestyle was included in the AHA Cardiovascular Health score (Life's Simple 7 [LS7]), subsequently updated to Life's Simple 8 [LS8]. Apart from the importance of controlling conventional cardiovascular risk factors, increasing evidence supports the contributory role of cardiovascular hormones. Higher levels of natriuretic peptides (NPs) and lower levels of renin and aldosterone were significantly associated to CVH. NT-proBNP levels showed a direct relationship with CVH scores in large general Caucasian populations, being also a marker of CVH changes and a predictor of future adverse events. On the other hand, renin and aldosterone were inversely related to CVH scores. In contrast, the counter-regulatory angiotensins [Ang (1-7) acting through Mas receptor, Ang (1-9) acting through Angiotensin Type 2 receptor, and alamandine] strengthen the beneficial properties of NPs. This evidence can be explained by both the effects on systemic hemodynamic and possible pleiotropic local functions regulating different pathways involved in the maintenance of CVH. Based on the current evidence, circulating levels of NT-proBNP, renin and aldosterone may affect CVH in apparently asymptomatic individuals and represent additional markers of residual cardiovascular risk. [ABSTRACT FROM AUTHOR]

Background/Objectives: The COVID-19 pandemic caused healthcare managers to reallocate resources from other areas in order to handle the outbreak. Cardiovascular usual care was especially affected during the first wave. Methods: We analyzed the short- and mid-term impact of the resource reallocation on cardiovascular health, focusing on the Balearic Islands in Spain. Data from 2019 to 2021 of the regional healthcare system and from the national and regional stats center were collected in order to analyze the variations in type of admissions, main causes of cardiovascular mortality, and the correlation between the monthly variation in those causes of mortality and total cardiovascular mortality. Results: The year 2021 showed worse results in terms of healthcare outcomes compared to the pre-pandemic period, with a population-adjusted cardiovascular mortality increase of 4.8% and heart failure and hypertension being the main drivers (6.4% and 26.45%, respectively). However, this impact was not homogeneous in both pandemic years. In 2020, the main driver for the cardiovascular mortality increase was myocardial infarction (R Pearson = 0.655/p = 0.021). On the other hand, chronic conditions such as heart failure and hypertension led to the increase in cardiovascular mortality in 2021 (R Pearson = 0.671/p = 0.017 and R Pearson = 0.619/p = 0.032, respectively). In-hospital resources for COVID-19 showed a positive correlation to cardiovascular mortality in 2021; however, it did not reach statistical significance (R Pearson = 0.41/p = 0.1). Conclusions: Mid-term cardiovascular health worsened in the Spanish Balearic Island region, with hypertension and heart failure being the main drivers, with important differences in influence between 2020 and 2021. We found a correlation between COVID-19 in-hospital resource allocation and total cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Purpose: Evidence concerning the effect of cardiovascular health (CVH) on the risk of metabolic dysfunctional-associated steatotic liver disease (MASLD) is scarce. This study aimed to investigate the association between CVH and MASLD. Methods: 5680 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey 2017-March 2020 were included. Life's essential 8 (LE8) was applied to assess CVH. Weighted binary logistic regression was employed to calculate the odds ratio (OR) and 95% confidence interval (CI) to investigate the association of CVH with MASLD. Restricted cubic spline (RCS) was conducted to explore the dose-response association between LE8 and its subscales scores with MASLD. Results: Among 5680 participants, 724, 3901, and 1055 had low, moderate, and high CVH levels, respectively, with a MASLD diagnosis prevalence of 36.83%. In the fully adjusted logistic regression model, ORs for MASLD were 0.50 (95% CI, 0.37–0.69) for participants with moderate CVH and 0.21 (95% CI, 0.13–0.34) for those with high CVH, when compared to those with low CVH (P < 0.001 for trend). OR for MASLD was 0.68 (95% CI, 0.61–0.77) for each 10-point increase in LE8 score. RCS model demonstrated a non-linear dose-response relationship between LE8 score and health factors score with MASLD, while a linear relationship was found between health behaviors score and MASLD. Subgroup analysis showed a consistent negative correlation between LE8 score and MASLD, and sensitivity analysis validated the reliability of these findings. Conclusions: Higher LE8 score was associated with a lower risk of MASLD. Encouraging adherence to optimal CVH levels may help mitigate the burden of MASLD. [ABSTRACT FROM AUTHOR]

Aim To investigate the association between cardiovascular health (CVH) score based on life􀆳s essential 8 (LE8) on cognitive function and the mediation role of neutrophil-to-lymphocyte ratio (NLR) between them in older adults, providing basis for the prevention and control of cognitive impairment. Methods The study population was selected from the National Health and Nutrition Examination Survey (NHANES) 2011--2014 two cycles of 60 years and above, demographic characteristics, medical history and other variables were collected, the participants􀆳 CVH scores were calculated according to LE8 defined by American Heart Association, and cognitive function was assessed using the digit symbol substitution test. The relationship between CVH and cognitive function was explored using a weighted linear regression analysis, and the dose-response relationship was analyzed using a restricted cubic spline. Moreover, mediation analysis was used to explore the role of NLR in mediating the relationship between CVH score and cognitive function. Results A total of 2 510 participants were included in this study. After adjusting for relevant factors, cognitive function was positively associated with moderate CVH group score (β =3. 36, 95% CI: 1. 43 ~ 5. 30) and high CVH group score (β =6. 01, 95%CI: 2. 89 ~ 9. 13) compared with the low CVH group score. The LE8 single factor of diet score (β = 0. 04, 95%CI: 0. 01 ~ 0. 06), physical activity score (β =0. 04, 95% CI: 0. 02 ~ 0. 05), tobacco exposure score (β = 0. 05, 95%CI: 0. 02 ~0. 08), blood pressure score (β = 0. 03, 95% CI: 0. 01 ~ 0. 05) and blood glucose score (β = 0. 06, 95% CI: 0. 03 ~ 0. 09) were positively correlated with cognitive function score. The results of restricted cubic splines showed that the score of CVH was linear positively correlated with the score of cognitive function. The indirect effect of CVH on cognitive function via NLR was 0. 002 (P>0. 05), and the proportion of mediating effect was 1. 29% (P> 0. 05), indicating the mediating effect of NLR on the relationship between CVH score and cognitive function was not significant. Conclusions The CVH score based on the LE8 was positively correlated with cognitive function in older adults, underscoring the crucial role of maintaining optimal CVH levels in supporting cognitive health. However, the NLR, as an indicator of inflammation, did not exhibit a significant mediating effect between the CVH score and cognitive function. The relationship between these variables might be influenced by other mechanisms. [ABSTRACT FROM AUTHOR]

Introduction: There are limited data on the prevalence of cardiovascular risk factors/diseases (diabetes, obesity, hypertension, and dyslipidemia) and their composite scores reflecting overall cardiovascular health among young (< 50 years old) married couples. Methods: We have an established longitudinal prospective cohort of postpartum women with a history of hyperglycemia [pre-existing diabetes (PED; n = 101), overt diabetes in pregnancy (ODiP; n = 92), gestational diabetes (GDM; n = 643)], and normoglycemia (n = 183) in pregnancy and their spouses (n = 819). In this study, we report data from baseline cross-sectional evaluation of these 819 young couples regarding the burden of cardiovascular risk factors/diseases, their concordance and associations. Results: The mean (SD) age was 33.5 (4.9) years for women and 36.9 (5.4) years for men, and the evaluation was performed at a median (IQR) postpartum interval of 30 (20–45) months. Diabetes, hypertension, obesity, and dyslipidemia were present in 25.0%, 6.9%, 25.6%, and 4.0% of women and 15.8%, 20.2%, 14.3%, and 8.2% of men, respectively. Among men, dysglycemia (diabetes/prediabetes) and adverse cardiovascular score (average/poor) showed a significant trend in progression according to the antenatal categories of their partner (highest in DIP, intermediate in GDM, and lowest in normoglycemia). The concordance was higher for adverse cardiovascular score (58.5%), overweight/obesity (48.7%), and dysglycemia (42.4%) compared to prehypertension/hypertension (29.2%) and hypercholesterolemia (8.2%). The odds ratios were significant for all associations evaluated, except for elevated blood pressure, being strongest (OR > 2.0) for overweight/obesity and adverse cardiovascular score. Conclusions: Nearly three in five young couples evaluated in the study showed concordance for adverse cardiovascular scores. The cardiovascular risk in men increased in a graded manner across the increasing severity of antenatal glycemic categories of their partners. Plain Language Summary: There is a lack of data on the comprehensive cardiovascular health scores proposed by the American Heart Association for women with prior gestational diabetes and their spouses. Furthermore, the risk of cardiometabolic risk factors for couples regarding different antenatal glycemic categories (normoglycemia, gestational diabetes, and diabetes in pregnancy) of the women has not been evaluated. In our CHIP-F study (Cohort Study of Indian Women with Hyperglycemia in Pregnancy and their Families), we have established a relatively large cohort of women and their spouses. We evaluated for diabetes, obesity, hypertension, dyslipidemia, and their composite scores, reflecting overall cardiovascular health among young (< 50 years old) married couples. We found that the burden of cardiometabolic risk factors among spouses of women who had either gestational diabetes or diabetes in pregnancy is substantial. Among men, dysglycemia (diabetes/prediabetes) and adverse cardiovascular score (average/poor) showed a significant trend in progression according to the antenatal categories of their partner (highest in DIP, intermediate in GDM, and lowest in normoglycemia). The concordance was higher for adverse cardiovascular score, overweight/obesity, and dysglycemia compared to prehypertension/hypertension and hypercholesterolemia. Nearly 60% of the young couples evaluated in the study showed concordance for adverse cardiovascular scores. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) remains the leading cause of mortality in the U.S. accounting for 1 in 4 deaths each year. Environmental factors, such as neighborhood safety, may increase the risk of CVD. Therefore, the current study assessed perceived neighborhood safety and its association with CVD risk factors (i.e. dyslipidemia, hypertension, type II diabetes) among 663 adults (mean age: 49.97 years, 61.24% female, 78.28% White). Participants completed self-report measures as part of a larger study of environmental influences on cardiac health. Results indicated that individuals reporting low perceived neighborhood safety had greater odds of having at least one CVD risk factor (OR = 2.76, 95% CI: 1.46, 5.22) compared to those with high perceived safety. There was a significant interaction between gender and the presence of at least one CVD risk factor in relation to perceived neighborhood safety. Low perceived neighborhood safety was associated with greater odds of having at least one CVD risk factor among males (OR = 5.48, 95% C.I: 1.82, 16.52) but not females. These findings suggest that low perceived safety is associated with CVD risk factors, especially among males. Future work should seek to better understand the interaction by gender in the relationship between perceived safety and CVD risk factors. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) affects adults globally. People with intellectual disabilities (PWID) may be at higher risk of CVD and associated risk factors (e.g. obesity, hypertension, and diabetes). We developed Pay Attention to Hypertension (PAtH), a cardiovascular health promotion intervention, and tested its impact on changes in blood pressure (BP), lifestyle behaviours and health‐related empowerment among PWID. Methods: PAtH was developed with a Special Olympics community organisation that supports PWID in developing self‐confidence and social skills through participation in sports. The 6‐month intervention consisted of 1‐h individualised virtual sessions delivered monthly by nursing students/novice nurses. Sessions covered specific themes, including monitoring BP, adopting healthy lifestyles and managing stress, and were individually tailored to the capacities and needs of participants. A single group pre–post‐intervention design was used to assess the intervention's effects among participants who completed the intervention and data collection. Data included baseline and follow‐up BP measurements from 7‐day logbooks and questionnaires assessing lifestyle behaviours [physical activity (PA), screen time and diet], and health‐related empowerment. Results: Seventy‐four participants were included in the analyses. Between baseline and follow‐up, there were no changes in systolic and diastolic BP, PA or leisure screen time. The proportion of participants who reported adding salt when cooking decreased from baseline to follow‐up (19.7% vs. 12.7%, P = 0.034), and we found improvements for several items measuring health‐related empowerment (P ≤ 0.003). Conclusion: Improvements in health‐related empowerment were found following PAtH. More intensive interventions may be needed to result in changes in lifestyle behaviours and BP. The integration of adapted cardiovascular health promotion initiatives within well‐established community organisations such as Special Olympics is a promising avenue to contribute to cardiovascular health promotion among PWID. [ABSTRACT FROM AUTHOR]

Cardiovascular health is influenced by various factors, including sarcopenia and depression. It has been demonstrated that sarcopenia has a negative impact on cardiovascular disease, with depression also being a contributing factor. However, the complex interplay between sarcopenia, depressive symptoms, and cardiovascular health in middle-aged and elderly populations is not fully explored. A total of 23,445 participants participated in China Health and Retirement Longitudinal Study and completed relevant measurements, including the Centre for Epidemiological Studies Depression Scale. The study also assessed sarcopenia and cardiovascular health score. The focus of the study was to test whether the association between sarcopenia and cardiovascular health scores was mediated by depression using PROCESS macros in R 4.3.2. Sensitivity analyses were conducted to affirm the robustness of our findings. The study revealed a partial mediation between sarcopenia and cardiovascular health score among the middle and elder adults, mediated by depression. Sarcopenia had a significant negative correlation with cardiovascular health score (B = −12.404, P < 0.05), and depression also showed a significant negative correlation (B = −1.515, P < 0.001). The results support the notion that depression partially mediated the association between sarcopenia and cardiovascular health score. Therefore, interventions aimed at improving mood and addressing other cardiovascular risk factors may help alleviate the adverse effects of sarcopenia and potentially reduce the progression to cardiovascular disease. • Our research aims to explore how depression mediates the relationship between sarcopenia and cardiovascular health. • We employed robust statistical techniques, including mediation analysis and sensitivity analyses, to confirm the robustness of our findings. • The study demonstrates a significant mediating role of depression, suggesting interventions targeting depressive symptoms in sarcopenic populations might help mitigate cardiovascular health risks. [ABSTRACT FROM AUTHOR]