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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]

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]

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]

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]

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]

Purpose of Review: This literature review is intended to highlight recent correlations between urologic, heart and overall health by emphasizing healthy eating patterns, physical activity, alcohol minimization and tobacco elimination, healthy sleep, weight, cholesterol, blood sugar, blood pressure management, and mental health awareness. Recent Findings: Meta-analyses, systematic reviews, and clinical studies espouse a unified message for prevention, reducing the risk of disease recurrence, progression, complementing conventional medical intervention efficacy, and mitigating treatment side effects. Limiting or eliminating alcohol consumption could be considered an independent recommendation and adding a mental health and miscellaneous (genetic risk and lifestyle, planetary health, HPV or other vaccination awareness, spirituality, etc.) category could allow for individualized educational opportunities, synergism appreciation, and self-improvement. Summary: Urologic healthcare professionals have the potential to strengthen the collective public health goal of improving the quality and quantity of the lives of patients able to adhere to these heart healthy recommendations. [ABSTRACT FROM AUTHOR]

A limited number of cohort studies have explored the impact of serum essential metal elements on blood pressure (BP) or glycolipids and their regulatory mechanism in children. This study aimed to investigate the relationship between serum metal concentrations of iron (Fe), zinc (Zn), calcium (Ca), copper (Cu), and magnesium (Mg) and BP in children, and explore the potential mediating effects of glycolipid profiles. This cohort study included 1993 children (3566 BP measurements) aged 6–14 years in Chongqing, China. Serum essential metals, BP, lipid profiles, and glucose and insulin levels were measured. The relationship between serum metal levels and BP was analyzed using generalized linear and regression models, and a mediation analysis was performed to examine the potential mediating role of glycolipids. After adjusting for confounders, positive associations were found between serum Fe and Zn levels and BP parameters (all P < 0.05). A "U" style relationship between Cu and BP was found. Stronger associations were found in children aged ≤ 10 years, with sex-specific differences for Fe, Zn, and Cu. The relationship between elevated BP and serum Mg and Ca was not found. Our study found that triglycerides showed a significant relationship with Fe and Zn levels (P < 0.005). Moreover, triglycerides, partially mediate the effects of Zn on elevated BP. Serum Fe, Zn, and Cu concentrations were associated with BP in children, and age and sex differences were observed. Triglycerides may play a mediating role. These findings highlight the importance of maintaining an optimal serum essential metal status for cardiovascular health in children and suggest potential early prevention strategies. [ABSTRACT FROM AUTHOR]

The combined effect of cardiovascular risk factors on breast cancer in women is unknown. The relationship between genetic risk combined with cardiovascular health (CVH) levels and breast cancer has not been confirmed. This study aims to explore the relationship between CVH level based on life's essential 8 (LE8) score and breast cancer risk in women with different menopausal statuses and to estimate further the effect of CVH level combined with genetic susceptibility on breast cancer risk. A total of 118,911 women from UK Biobank were included in the study, including 22,676 premenopausal women and 96,235 postmenopausal women. The association between the CVH level and the risk of breast cancer in women with different menopausal statuses was assessed using the Cox proportional hazards regression models, with the healthiest CVH group as the reference. In addition, risk ratios (HRs) and 95% confidence intervals (95% CIs) for the joint effect of the CVH level and polygenic risk score (PRS) were calculated using the PRS from the UK Biobank. During a mean follow-up period of 13.8 years, we observed 733 cases and 3,645 cases of breast cancer in premenopausal and postmenopausal women, respectively. In premenopausal women, the risk of breast cancer was significantly increased in the intermediate CVH group (HR, 1.28; 95%CI 1.08–1.52) and the low CVH group (HR, 1.44; 95%CI 1.13–1.85). In postmenopausal women, the risk of incidence was also significantly increased in the intermediate CVH group (HR, 1.20; 95%CI 1.07–1.32) and the low CVH group (HR, 1.34; 95%CI 1.17–1.54). In the joint effect analysis, the risk of breast cancer for women in the low CVH group and the high genetic risk group was highest in both premenopausal (HR, 8.26; 95%CI 4.44–15.35) and postmenopausal (HR, 8.10; 95%CI 5.50–11.93) women. Women with lower LE8 scores and higher genetic susceptibility have the higher risk of breast cancer. This suggests that women with lower levels of CVH and higher genetic susceptibility have an increased risk of breast cancer under different menopausal statuses. [ABSTRACT FROM AUTHOR]

The American Heart Association has updated the cardiovascular health (CVH) assessment tool, referred to as the Life's Essential 8 (LE8). Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease worldwide and is linked to an elevated risk of mortality. We aimed to explore the association of LE8 with all cause and cause-specific mortality in MASLD in a prospective cohort study. A total of 10,050 participants with MASLD from the NHANES 2005–2018 dataset were included in the study. LE8 was evaluated by combining four health behaviors and four health factors, with scores of 0–49 categorized as low CVH, 50–79 as moderate CVH, and 80–100 as high CVH. In the fully adjusted model, each one-point increase in the LE8 score corresponded to a 2.7, 2.7, and 1.6% decrease in all-cause, CVD, and cancer mortality risk, respectively, in people with MASLD. Compared to low CVH, being in moderate/high CVH was negatively associated with most mortality outcomes, while health factors lost significant association with cancer mortality. [ABSTRACT FROM AUTHOR]

Climate change can contribute to the increase in the prevalence of cardiovascular (CV) diseases, the leading cause of global deaths. Accordingly, many big cities are interested in increasing their residents’ resilience against heat waves. With these issues in mind, the aim of our study was to identify salient features of urban areas and to analyze the effect of such features on population vulnerability to heat (VtoH) as it relates to CV health. This approach was developed and tested in the city of Milan, Italy, considering the summer periods (May–September) of 2017–2022. Milan was divided into 86 districts and 11 features were considered. K-means was applied for clustering, and both spatial and non-spatial regression were used to study the VtoH, defined as the percentage of CV emergencies on a given heat day and on the day after, compared to the total number of CV emergencies. Socio-urban features were spatially non-stationary and three different clusters of districts were identified. In the whole city, regression analysis depicted a spatial relationship between the focal features and the VtoH, with the model estimating a significant effect in five variables: mean summer temperature, density of drinking water fountains and percentages of elderly, female and graduate residents. Three additional features were found to be significant in only some of the cities’ clusters. Our spatial analysis of CV health emergencies applied to the entire geographical area, rather than at the patient level, represents a relatively underexplored approach in public health-related research. The results of our study and future research taking this approach can inform solutions to equitably protect cities’ residents, which is important in the context of ongoing urbanization and climate change. [ABSTRACT FROM AUTHOR]

Background: Previous researches have reported the relationship between uric acid and cardiovascular disease. We aimed to investigate the association of Life's Essential 8, a recently updated measurement of cardiovascular health, with the prevalence of hyperuricemia (HUA) and gout among US adults. Additionally, we also explored the relationship between LE8 and all-cause mortality among patients with HUA or gout. Methods: Participants from the National Health and Nutrition Examination Survey in 2007–2016 were involved in this study. LE8 score was categorized into low, moderate, high CVH groups according to American Heart Association definitions. Multivariable logistic regression and cox regression analyses, restricted cubic spline models, subgroup analysis and sensitivity analysis were used to explore the associations. Results: A total of 23,619 adult participants were included in this study, which included 4,775 hyperuricemia patients and 1,055 gout patients. Among all participants, the overall median LE8 score was 65.62 (21.25) and the prevalence of hyperuricemia and gout of were 20.2% and 4.5%, respectively. After fully adjusted the potential confounders, participants in high CVH group had a lower prevalence of hyperuricemia and gout compared with the low CVH group, with a OR (95%CI) of 0.50 (0.39–0.63) and 0.50 (0.30–0.82), respectively. The restricted cubic spline showed a significantly inverse relationship between LE8 and hyperuricemia and gout. Similar patterns were also identified in the association between LE8 scores and all-cause mortality in HUA and gout patients. Conclusions: Higher LE8 scores are associated with lower risk and lower all-cause mortality of HUA and gout among US adults. Adherence to optimal CVH metrics may be an appropriate prevention and management strategy for reducing the socioeconomic burden of hyperuricemia and gout. [ABSTRACT FROM AUTHOR]

The 6-minute walk test (6MWT) is a well-known instrument for assessing cardiovascular patients’ functional capacity; yet, little is known about its potential as a prognostic marker in the metabolic syndrome (MetS) population. Apart from its main application in determining walking distance, the 6MWT provides insightful information about functional capacity, response to therapy, and diagnostic potential for a wide range of disorders. In this work, we integrated wearable device-collected ECG data for heart-rate variability (HRV) analysis to improve our evaluation of cardiac function in the MetS patient group. Our main objective was to assess, with a wrist-worn device, the respiratory and cardiovascular system exercise tolerance using the 6MWT. We designed an Android-based mobile application for automated signal monitoring and distance measurement to simplify data collecting and analysis. 27 individuals in all, ranging in age from 24 to 79, made up our cohort. Three key indicators were included into HRV analysis: Poincaré metrics, frequency domain, and time domain. We found strong correlations between these 2/3/6 HRV parameters and 6MWT results. The aim of this study was to use HRV analysis to evaluate the functional capacities of MetS patients in comparison to non-MetS people.Article Highlights: Advanced wearables monitor HRV, ECG, and SpO2 over the 6MWT, so improving cardiovascular assessments in MetS patients. Lower HRV is associated with lower walking distance, hence it highlights its possible use as a cardiovascular risk indicator in MetS. During the 6MWT, a user-friendly clinical mobile app supports real-time data collecting and analysis, so enhancing functional assessments. Important predictors of 6MWT performance, including age and BMI, provide insightful information for individualized treatment in MetS patients. [ABSTRACT FROM AUTHOR]

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Almond-based dairy alternatives have gained popularity for their plant-based origins, but they often suffer from low protein content and incomplete amino acid profiles compared to traditional dairy products. This study investigates the enhancement of protein quality and bioactive peptide production in almond-based dairy alternatives through lactic acid fermentation and enzyme-assisted hydrolysis, focusing on potential cardiovascular health benefits. Lactic acid bacteria (LAB) Case Studies: Enzymatic Treatment of Plant-Based Proteins for Improved Functional Properties strains such as Lactobacillus plantarum and Lactobacillus acidophilus were used to improve sensory properties, enhance nutrient bioavailability, and generate bioactive peptides. These peptides exhibit health-promoting activities such as angiotensin-converting enzyme (ACE) inhibition, antioxidant effects, and anti-inflammatory properties, all of which are critical for cardiovascular health. Enzyme-assisted hydrolysis further improves protein digestibility by breaking down almond proteins into smaller, more absorbable peptides. The dual approach of combining fermentation and enzymatic hydrolysis was found to optimize the production of bioactive peptides while enhancing the overall sensory profile and functionality of almond-based products. The study also highlights the need for further research into optimizing processing conditions, understanding the synergistic mechanisms of LAB fermentation and enzymatic hydrolysis, and validating the cardiovascular benefits of almond-derived bioactive peptides through clinical trials. These findings pave the way for developing functional almond-based products with enhanced nutritional profiles and potential heart-health benefits. [ABSTRACT FROM AUTHOR]

Purpose: Osteoarthritis (OA) often coexists with risk factors for cardiovascular disease (CVD), worsening symptoms and functional impairment. This cross-sectional study investigated the association between Life's Essential 8 (LE8) and disability in individuals with OA. Methods: Data from 8334 United States adults (aged ≥ 20) who participated in the 2005–2018 National Health and Nutrition Examination Survey (NHANES) with complete data on LE8 components and disability status were analyzed. LE8 components, including diet, physical activity (PA), nicotine exposure, sleep, body mass index (BMI), blood lipids, glucose, and blood pressure (BP), were scored on a 0–100 scale, categorizing cardiovascular health (CVH) as low, moderate, or high. Disability mainly caused by OA was assessed using a standardized physical functioning questionnaire. Association analyses were performed using multivariable logistic regression, adjusting for demographic, socioeconomic, lifestyle, and health-related covariates. Results: Individuals with CVH scores 10 points higher had a 15% lower prevalence of OA (95% CI 0.81–0.90). Individuals with OA were more than twice as likely to experience disability. High levels of CVH were associated with a lower prevalence of disability in various domains compared to low levels of CVH (all P < 0.05), such as in activities of daily living (OR 0.32, 95% CI 0.18–0.58). Among the LE8 components, BMI, PA, and sleep health were associated with disabilities in all domains, while blood lipid scores were not. Conclusion: A higher adherence to LE8 is associated with a lower prevalence of different types of disability in domains of physical functioning and functional limitations in individuals with OA. [ABSTRACT FROM AUTHOR]

Background: Despite its widespread adoption in cardiovascular research, the application of LE8 in other health conditions, particularly urgency urinary incontinence (UUI) and nocturia, has not been thoroughly investigated. Our study used the Life's Essential 8 (LE8) score to evaluate the relationship between cardiovascular health (CVH) and urge urinary incontinence and nocturia in adults. Methods: This analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011–2018. We used the LE8 score as the independent variable, and UUI and nocturia as the dependent variables. Multivariable logistic regression was conducted to explore the association between the LE8 score and the occurrence of UUI and nocturia. Results: The study included 12,566 adults aged 20 and older. After adjusting for potential confounders, a higher LE8 score was inversely associated with the risk of UUI (OR = 0.38; 95% CI: 0.27–0.52, p < 0.0001) and nocturia (OR = 0.53; 95% CI: 0.44–0.65, p < 0.0001). Conclusion: This cross-sectional study revealed an inverse relationship between the LE8 score and the likelihood of both UUI and nocturia. [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of diabetic nephropathy is well-documented to be multifactorial. However, research available on the association between cardiovascular health and diabetic nephropathy is limited. Thus, this study aimed to investigate these potential associations and provide guidance for disease prevention. Methods: We applied Life's Essential 8 (LE8) identified by the American Heart Association, which integrates multiple health behaviors and health factors to measure cardiovascular health. This study covered 4207 adults with diabetes from the National Health and Nutrition Examination Survey spanning 2007–2018. Weighted regression models assessed the estimated effect of LE8 score on the prevalence of diabetic nephropathy as well as their corresponding clinical indicators. Weighted restricted cubic spline models discussed the possible nonlinear dose–response relationships further. Subgroup analyses clarified the effects of other covariates on correlations. Results: After adjusting for all covariates, participants with moderate or high cardiovascular health showed a decreased prevalence of diabetic nephropathy (odds ratio [OR]:0.52; 95% confidence interval [CI]:0.42–0.63), and also a decrease in the urinary albumin-to-creatinine ratio [UACR] (β: – 0.83; 95% CI:– 1.00 to – 0.65). The prevalence of diabetic nephropathy and the level of UACR tended to decrease linearly as the total LE8 score increased (P for nonlinear > 0.05). Subgroup analyses showed that the effects of increased overall LE8 score and the specific cardiovascular health construct varied across age and obesity strata. Conclusion: Elevated overall LE8 score was significantly associated with a lower prevalence of diabetic nephropathy in U.S. adults, and the effects of the specific cardiovascular health construct on diabetic nephropathy and their corresponding clinical indicators varied. In all, maintaining good cardiovascular health by refining LE8 metrics may help reduce the adverse effects. [ABSTRACT FROM AUTHOR]

It is currently unclear whether there is a connection between Life's Essential 8 (LE8) and cardiovascular disease (CVD), as well as mortality in people with nonalcoholic fatty liver disease (NAFLD). Our goal was to explore these relationships by examining data collected in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. We identified eligible participants with NAFLD based on NHANES 2005–2018 data. CVD status was acquired through self-reported information, and using the National Death Index, mortality data were prospectively matched. The diagnosis of NAFLD relied on noninvasive biomarkers. The research involved 9094 individuals who were identified as having NAFLD, with a mean age of 52.05 years. Each incremental LE8 score exhibited a significant association, leading to a 3%, 3%, 4%, 3%, 3%, 4%, and 4% reduction in the odds of experiencing CVD, ischemic heart disease, congestive heart failure, coronary heart disease, heart attack, angina, and stroke in individuals with NAFLD. A strong correlation was found between maintaining a superior level of Cardiovascular Health (CVH), as shown by a LE8 score ranging from 80 to 100, and a reduced occurrence of CVD and its various forms in NAFLD (all p for trend < 0.0001). Likewise, LE8 demonstrated protective benefits on mortality in NAFLD, showing that following a high CVH (in contrast to low CVH) was linked to reductions of 64%, 71%, and 74% in all-cause, CVD, and cancer mortality, respectively. Restricted cubic spline analyses suggested noteworthy dose-response relationships between LE8 and CVD, specifically its types in NAFLD, and a nonlinear correlation with CVD mortality. Interaction analyses highlighted age and race as significant effect modifiers. CVH, as evaluated by LE8, demonstrated an independent association with decreased odds of CVD and mortality risk in individuals with NAFLD. Our findings substantiate that adhering to LE8 may alleviate the excessive burden of CVD and mortality in the context of NAFLD. [ABSTRACT FROM AUTHOR]

Purpose: Women with gestational diabetes mellitus (GDM) or obesity are vulnerable to impaired gestational cardiovascular health (CVH) and cardiovascular disease (CVD) in the future. It is unclear if prenatal vitamin D supplementation improves gestational CVH, especially in women at high risk for developing CVD. Our goal was to find out if vitamin D supplementation could protect against gestational CVH, including the women with GDM or obesity. Design: We randomly assigned women with a serum 25(OH)D concentration < 75 nmol/L to receive 1600 IU/d (intervention group) or 400 IU/d (control group) of vitamin D3 for two months at 24–28 weeks' gestation. The primary outcome was gestational CVH marks (lipids, inflammatory cytokines, endothelial function). Results: There were 1537 participants divided into the intervention (N = 766) and control groups (N = 771). No baseline differences existed among study groups in CVH markers. At the two-month visit, the intervention group's HDL-C levels (2.01 ± 0.39 VS 1.96 ± 0.39 mmol/L) were significantly higher than those of the control group, while the hs-CRP levels were significantly lower (3.28 ± 2.02 VS 3.64 ± 2.42 mg/L). Subgroup analysis found that HDL-C, TC, hs-CRP, E-Selectin, and SBP were improved in the intervention group among women with GDM or overweight/obesity, and the improvement was not found in women without GDM or overweight/obesity. Vitamin D supplementation significantly decreased the mean triglyceride-glucose index at the two-month visit in women with GDM. Conclusions: Vitamin D supplementation at mid-gestation might optimize the gestational CVH status for pregnant women, particularly the women with GDM or obesity, which is advantageous for later-life primary prevention of CVD. Clinical trial registration: The Chinese Clinical Trial Registry (ChiCTR2100051914, 10/9/2021, Prospective registered, https://www.chictr.org.cn/showproj.aspx?proj=134700). [ABSTRACT FROM AUTHOR]

This study compared blood pressure (BP) and heart rate variability (HRV) values considering the angiotensin-converting enzyme (ACE) polymorphisms and physical activity (PA) level. Participants were stratified according to their ACE polymorphism and PA level. Polymerase chain reaction (PCR) was used to detect polymorphisms and PA level was assessed by questionnaire. Participants had their BP measured by an oscillometer and the HRV rerded using a heart monitor. Participants grouped by polymorphism II showed higher values of root mean square successive difference when compared to individuals with DD polymorphism. "Highly active", compared to "active", individuals exhibited a lower diastolic BP. There was no statistically significant difference in the behavior of the dependent variables between the different PA levels within each polymorphism. Polymorphism II attenuated parasympathetic activity in cardiac autonomic modulation and the "highly active" group displayed lower values of diastolic BP. PA level did not affect any variable when polymorphisms were considered. [ABSTRACT FROM AUTHOR]

Estrone (E1) constitutes the primary component in oral conjugated equine estrogens (CEEs) and serves as the principal estrogen precursor in the female circulation in the post-menopause. E1 induces endothelium-dependent vasodilation and activate PI3K/NO/cGMP signaling. To assess whether E1 mitigates vascular dysfunction associated with postmenopause and explore the underlying mechanisms, we examined the vascular effects of E1 in ovariectomized (OVX) rats, a postmenopausal experimental model. Blood pressure was measured using tail-cuff plethysmography, and aortic rings were isolated to assess responses to phenylephrine, acetylcholine (ACh), and sodium nitroprusside. Responses to ACh in rings pre-incubated with superoxide dismutase (SOD), catalase (CAT), or apocynin were also evaluated. Protein expression of SOD, CAT, NOX1, NOX2, and NOX4 was determined by Western blotting. E1 treatment resulted in decreased body weight and retroperitoneal fat, increased uterine weight, and prevented elevated blood pressure in the OVX group. Furthermore, E1 improved endothelium-dependent ACh vasodilation, activated compensatory antioxidant mechanisms – i.e. increased SOD and CAT antioxidant enzymes activity, and decreased NOX4 expression. This, in turn, helped prevent oxidative stress and endothelial dysfunction in OVX rats. Additionally, E1 treatment reversed the increased total LDL cholesterol observed in the OVX group. The findings underscore protective effects of E1 on the cardiovascular system, counteracting OVX-related oxidative stress and endothelial dysfunction in Wistar rats. E1 exhibits promising therapeutic benefits for managing cardiovascular health, particularly in postmenopausal conditions. [ABSTRACT FROM AUTHOR]

The American Heart Association (AHA) recently redefined cardiovascular health (CVH) with the introduction of Life's Essential 8 (LE8), which encompasses eight areas (diet, physical activity, nicotine exposure, sleep duration body mass index, non-HDL cholesterol, blood glucose, and blood pressure). This study aimed to explore the relationships between both the aggregate and individual CVH metrics, as defined by Life's Essential 8, and cognitive function in older adults in the United States. This cross-sectional, population-based study analyzed data from the National Health and Nutrition Examination Survey conducted between 2011 and 2014, focusing on individuals aged 60 years and older. CVH was categorized as low (0–49), moderate (50–79), or high (80–100). Cognitive function was assessed through the CERAD tests, Animal Fluency test, and Digit Symbol Substitution test. Multivariable logistic models and restricted cubic spline models were employed to investigate these associations. This study included a total of 2279 older adults in the United States. Only 11% of adults achieved a high total CVH score, while 12% had a low score. After further adjustment for potential confounding factors, higher LE8 scores were significantly associated with higher scores on CERAD: delayed recall score (0.02[0.01, 0.03]; P < 0.001), CERAD: total score (3 recall trials) (0.04[0.02, 0.06]; P < 0.001), animal fluency: total score (0.09[0.05, 0.12]; P < 0.001), and digit symbol: score (0.29[0.18, 0.41]; P < 0.001), demonstrating a linear dose–response relationship. Similar patterns were also observed in the associations between health behavior and health factor scores with cognitive function tests. LE8 scores exhibited positive linear associations with cognitive function. Maintaining better levels of CVH may be associated with higher levels of cognitive function in older Americans, but further research is needed to confirm the causal and temporal relationships between LE8 and cognitive function. [ABSTRACT FROM AUTHOR]

Background: Metabolic unhealth (MUH) is closely associated with cardiovascular disease (CVD). Life's Essential 8 (LE8), a recently updated cardiovascular health (CVH) assessment, has some overlapping indicators with MUH but is more comprehensive and complicated than MUH. Given the close relationship between them, it is important to compare these two measurements. Methods: This population-based cross-sectional survey included 20- to 80-year-old individuals from 7 National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018. Based on the parameters provided by the American Heart Association, the LE8 score (which ranges from 0 to 100) was used to classify CVH into three categories: low (0–49), moderate (50–79), and high (80–100). The MUH status was evaluated by blood glucose, blood pressure, and blood lipids. The associations were assessed by multivariable regression analysis, subgroup analysis, restricted cubic spline models, and sensitivity analysis. Results: A total of 22,582 participants were enrolled (median of age was 45 years old), among them, 11,127 were female (weighted percentage, 49%) and 16,595 were classified as MUH (weighted percentage, 73.5%). The weighted median LE8 scores of metabolic health (MH) and MUH individuals are 73.75 and 59.38, respectively. Higher LE8 scores were linked to lower risks of MUH (odds ratio [OR] for every 10 scores increase, 0.53; 95% CI 0.51–0.55), and a nonlinear dose–response relationship was seen after the adjustment of potential confounders. This negative correlation between LE8 scores, and MUH was strengthened among elderly population. Conclusions: Higher LE8 and its subscales scores were inversely and nonlinearly linked with the lower presence of MUH. MUH is consistent with LE8 scores, which can be considered as an alternative indicator when it is difficult to collect the information of health behaviors. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) exhibits a robust association with cardiovascular disease. Our study aims to elucidate the correlation between RA prevalence and Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH). Methods and results: We conducted a population-based cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2018. Utilizing multivariable logistic and restricted cubic spline models, we explored the relationship between LE8 and RA. Our analysis included 17,263 participants. We found that higher LE8 scores were closely associated with reduced odds of RA (odds ratio for each 10-point increase, 0.91 (95% CI, 0.75–0.87)). Furthermore, we observed a nonlinear association between LE8 and RA after adjusting for potential confounders. Specifically, higher scores for sleep health, nicotine exposure, body mass index, and blood pressure within the LE8 components were significantly correlated with a lower risk of RA. Additionally, the inverse relationship between LE8 scores and RA was notably stronger among young and female individuals. Conclusion: Our findings suggest a negative correlation between LE8 and RA prevalence, indicating that adherence to the lifestyle defined by LE8 may confer protective effects against RA. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases are one of the prime causes of mortality globally. Therefore, concerted efforts are made to prevent or manage disruptions from normal functioning of the cardiovascular system. Disruption in lipid metabolism is a major contributor to cardiovascular dysfunction. This review examines how lecithin impacts lipid metabolism and cardiovascular health. It emphasizes lecithin's ability to reduce excess low-density lipoproteins (LDL) while specifically promoting the synthesis of high-density lipoprotein (HDL) particles, thus contributing to clearer understanding of its role in cardiovascular well-being. Emphasizing the importance of lecithin cholesterol acyltransferase (LCAT) in the reverse cholesterol transport (RCT) process, the article delves into its contribution in removing surplus cholesterol from cells. This review aims to clarify existing literature on lipid metabolism, providing insights for targeted strategies in the prevention and management of atherosclerotic cardiovascular disease (ASCVD). This review summarizes the potential of lecithin in cardiovascular health and the role of LCAT in cholesterol metabolism modulation, based on articles from 2000 to 2023 sourced from databases like MEDLINE, PubMed and the Scientific Electronic Library Online. Main body: While studies suggest a positive correlation between increased LCAT activities, reduced LDL particle size and elevated serum levels of triglyceride-rich lipoprotein (TRL) markers in individuals at risk of ASCVD, the review acknowledges existing controversies. The precise nature of LCAT's potential adverse effects remains uncertain, with varying reports in the literature. Notably, gastrointestinal symptoms such as diarrhea and nausea have been sporadically documented. Conclusions: The review calls for a comprehensive investigation into the complexities of LCAT's impact on cardiovascular health, recognizing the need for a nuanced understanding of its potential drawbacks. Despite indications of potential benefits, conflicting findings warrant further research to clarify LCAT's role in atherosclerosis. [ABSTRACT FROM AUTHOR]

Currently, a comprehensive assessment of the relationship between ideal cardiovascular health (CVH) indicators and cataract risk is lacking. Life's Essential 8 (LE8) is the latest concept proposed by the American Heart Association to comprehensively reflect CVH status. LE8 includes four health behaviors (diet, physical activity, smoking, and sleep) and four health factors (blood lipid, blood sugar, blood pressure, and body mass index). This study tried to evaluate the association between LE8 and cataract using data from National Health and Nutrition Examination Survey (NHANES) 2005–2008, a continuous research program which aims to monitor and evaluate the health and nutrition status of the US population. A cross-sectional study of 2720 non-cataract participants and 602 cataract participants. All participants were assigned to the poor, intermediate, and ideal CVH status groups based on LE8 score. Weighted multiple logistic regression was used to investigate the correlation between the LE8 score and cataract, as well as the correlation between each of the eight subitems and cataract, with potential confounding variables being adjusted. Then, restricted cubic spline analysis was used to further explore whether there was a nonlinear relationship between LE8 score and cataract. The proportion of cataract participants was 14.1%, 18.2%, and 20.6% in the ideal, intermediate, and poor CVH groups, respectively (P < 0.05). LE8 score was inversely associated with cataract risk, with each 10-point increase in LE8 score associated with a 14% reduction in cataract risk [odds ratio (OR) = 0.86, 95% confidence interval (CI): 0.79–0.93, P < 0.01]. Among all the LE8 subitems, physical activity, sleep, and blood glucose were significantly associated with cataract risk (all P < 0.05). Better CVH, defined by a higher LE8 score, is associated with a lower cataract risk. Efforts to improve LE8 score (especially when it comes to physical activity, sleep, and blood glucose) may serve as a novel strategy to help reduce the risk of cataract. [ABSTRACT FROM AUTHOR]

Background: Nanoplastics (NPs) have emerged as significant environmental pollutants, raising concerns due to their ubiquitous presence and potential adverse effects on human health. The migration and fate of NPs in the environment are subjects of intense study, with human exposure pathways expanding through ingestion, inhalation, and dermal contact. Body: Studies indicate that NPs can infiltrate the cardiovascular system, potentially causing adverse effects. Mechanistic insights from in vitro and animal studies suggest that oxidative stress, inflammation, apoptosis, and mitochondrial dysfunction contribute to nanoplastic-induced cardiovascular toxicity. Animal models demonstrate altered heart rate, myocardial fibrosis, and dysfunction following NPs exposure, with specific adverse effects observed in cardiac valves and mitochondrial structure. Clinical studies provide further evidence of NPs accumulation in cardiovascular tissues, with implications for cardiovascular pathologies such as atherosclerosis and myocardial infarction. Notably, patients with higher levels of nanoplastics in carotid plaque exhibit an increased risk of adverse cardiovascular outcomes. Conclusion: However, challenges in studying nanoplastics persist, including methodological limitations, ethical considerations, and the need for standardized detection methods. Addressing these challenges requires interdisciplinary collaboration, innovative research approaches, and robust regulatory measures to mitigate NPs pollution and protect cardiovascular health. [ABSTRACT FROM AUTHOR]

Purpose: Dietary nitrate (NO3−) supplementation can lower systolic blood pressure (SBP) and improve exercise performance. Salivary flow rate (SFR) and pH are key determinants of oral NO3− reduction and purported to peak in the afternoon. We tested the hypotheses that NO3−-rich beetroot juice (BR) would increase plasma [nitrite] ([NO2−]), lower SBP and improve exercise performance to a greater extent in the afternoon (AFT) compared to the morning (MORN) and evening (EVE). Method: Twelve males completed six experimental visits in a repeated-measures, crossover design. NO3−-depleted beetroot juice (PL) or BR (~ 13 mmol NO3−) were ingested in the MORN, AFT and EVE. SFR and pH, salivary and plasma [NO3−] and [NO2−], brachial SBP and central SBP were measured pre and post supplementation. A severe-intensity exercise tolerance test was completed to determine cycling time to exhaustion (TTE). Results: There were no between-condition differences in mean SFR or salivary pH. The elevation in plasma [NO2−] after BR ingestion was not different between BR-MORN, BR-AFT and BR-EVE. Brachial SBP was unchanged following BR supplementation in all conditions. Central SBP was reduced in BR-MORN (− 3 ± 4 mmHg), BR-AFT (− 4 ± 3 mmHg), and BR-EVE (− 2 ± 3 mmHg), with no differences between timepoints. TTE was not different between BR and PL at any timepoint. Conclusion: Acute BR supplementation was ineffective at improving TTE and brachial SBP and similarly effective at increasing plasma [NO2−] and lowering central SBP across the day, which may have implications for informing NO3− supplementation strategies. [ABSTRACT FROM AUTHOR]

Background: Practicing sports during childhood and adolescence provides benefits to cardiac autonomic modulation (CAM) at these stages of life. However, it is not known whether these benefits to CAM persist into adulthood. Therefore, the objective of this study was to analyze the association of early sports practice (sports practice in childhood and/or adolescence) with CAM in adult life, regardless of habitual moderate-to-vigorous PA. Methods: The sample of the present study consisted of 242 adults (141 women and 101 men; age: 41.99 ± 16.24). The assessment of CAM was performed using heart rate variability indices. Sports practice in childhood and adolescence was assessed using a questionnaire. The intensity of physical activity was assessed using accelerometry. To analyze the association between previous sports practice (childhood and/or adolescence) and CAM, the Generalized Linear Model was adopted, considering CAM indices as continuous variables and early sports practice as a 3-fold factor (no sports practice; sports practice in childhood or adolescence; and sports practice in both childhood and adolescence) adjusted by sex, age, socioeconomic condition, and moderate to vigorous PA. Results: Sports practice in childhood was associated with the average standard deviation of all normal RR intervals expressed in milliseconds (SDNN): β = 5.89; 95%CI: 0.25;11.52, and the standard deviation of the long-term intervals between consecutive heartbeats (SD2): β = 7.63; 95%CI:1.04; 14.23 indices. Sports practice in adolescence was associated in adulthood with the SD2 index: β = 7.37; 95%CI: 0.71;14.04. Sports practice in at least one of the periods (childhood or adolescence) was significantly associated with the square root of the mean square of the differences between adjacent normal RR intervals for a period of time expressed in milliseconds (RMSSD) (β = 8.86; 95%CI = 0.71;17.01), and the standard deviation of the instantaneous beat to beat variability (SD1) (β = 6.21; 95%CI = 0.45;11.97). Sports practice at both stages of life was significantly associated with better SDNN (β = 7.70; 95%CI = 1.16;14.23) and SD2 (β = 10.18; 95%CI = 2.51;17.85). Conclusion: Early sports practice was associated with better CAM in adulthood, independently of the current physical activity level. Based on these findings, sports practice is encouraged from childhood and adolescence, for benefits to CAM in adult life. Key Points: Few studies have verified whether the practice of sports in childhood and adolescence could be associated with better CAM in adult life. Sports practice in childhood and/or in adolescence was associated with better CAM in adult life, both when analyzed separately and when combined. Early sports practice was associated with indices of cardiac autonomic modulation in adulthood that reflect global variability (SNDD and SD2) and parasympathetic modulation (RMSSD and SD1). [ABSTRACT FROM AUTHOR]

Introduction: This is a 12-weeks randomized controlled trial examining the effects of aerobic exercise (AE), computerized cognitive training (CCT) and their combination (COMB). We aim to investigate their impact on cardiovascular health and white matter (WM) integrity and how they contribute to the cognitive benefits. Methods: 109 participants were recruited and 82 (62% female; age = 58.38 ± 5.47) finished the intervention with > 80% adherence. We report changes in cardiovascular risk factors and WM integrity (fractional anisotropy (FA); mean diffusivity (MD)), how they might be related to changes in physical activity, age and sex, and their potential role as mediators in cognitive improvements. Results: A decrease in BMI (SMD = − 0.32, p = 0.039), waist circumference (SMD = − 0.42, p = 0.003) and diastolic blood pressure (DBP) (SMD = − 0.42, p = 0.006) in the AE group and a decrease in BMI (SMD = − 0.34, p = 0.031) and DBP (SMD = − 0.32, p = 0.034) in the COMB group compared to the waitlist control group was observed. We also found decreased global MD in the CCT group (SMD = − 0.34; p = 0.032) and significant intervention-related changes in FA and MD in the frontal and temporal lobes in the COMB group. Conclusions: We found changes in anthropometric measures that suggest initial benefits on cardiovascular health after only 12 weeks of AE and changes in WM microstructure in the CCT and COMB groups. These results add evidence of the clinical relevance of lifestyle interventions and the potential benefits when combining them. Clinical Trial Registration: ClinicalTrials.gov NCT031123900. [ABSTRACT FROM AUTHOR]

Purpose: The incidence of kidney stone disease has increased worldwide, resulting in high medical costs and social burden. Kidney stone disease shares some common features with the risk factors of cardiovascular diseases (CVDs). We investigated the association between cardiovascular health (CVH) based on the Life’s Essential 8 (LE8) score developed by the American Heart Association and the incidence of kidney stone disease. Methods: We analyzed the data of 29,469 US adults aged 20 years or above from the National Health and Nutrition Examination Survey, 2007–2018. According to the LE8 score, CVH was divided into three categories: poor, intermediate, and ideal. Logistic regression was used to determine the association between CVH and the incidence of kidney stone disease by estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results: The average age of the participants was 48.6 years, and 50% of the participants were women. The numbers of participants with poor, intermediate, and ideal CVH were 4149, 19,782, and 5538, respectively. After adjusting for related confounding factors, ideal CVH was associated with a reduction in the odds of kidney stone occurrence as compared to poor CVH (adjusted OR [aOR]: 0.45, 95% CI: 0.35–0.57, p < 0.001). Moreover, if the ideal CVH metrics was ≥ 6, the odds of kidney stone occurrence decreased by up to 61% (aOR: 0.39, 95% CI: 0.30–0.51). Conclusions: In the present study, ideal CVH, a factor indicative of a healthy lifestyle, was associated with lower odds of kidney stone occurrence. [ABSTRACT FROM AUTHOR]

Purpose of Review: Misalignment between the endogenous biological timing system and behavioral activities (i.e., sleep/wake, eating, activity) contributes to adverse cardiovascular health. In this review, we discuss the effects of recurring circadian misalignment on blood pressure regulation and the implications for hypertension development. Additionally, we highlight emerging therapeutic approaches designed to mitigate the negative cardiovascular consequences elicited by circadian disruption. Recent Findings: Circadian misalignment elicited by work schedules that require individuals to be awake during the biological night (i.e., shift work) alters 24-h blood pressure rhythms. Mechanistically, circadian misalignment appears to alter blood pressure via changes in autonomic nervous system balance, variations to sodium retention, dysregulation of endothelial vasodilatory responsiveness, and activation of proinflammatory mechanisms. Recurring circadian misalignment produced by a mismatch in sleep timing on free days vs. work days (i.e., social jetlag) appears to have no direct effects on prevailing blood pressure levels in healthy adults; though, circadian disruptions resulting from social jetlag may increase the risk of hypertension through enhanced sympathetic activation and/or obesity. Furthermore, social jetlag assessment may be a useful metric in shift work populations where the magnitude of circadian misalignment may be greater than in the general population. Summary: Circadian misalignment promotes unfavorable changes to 24-h blood pressure rhythms, most notably in shift working populations. While light therapy, melatonin supplementation, and the timing of drug administration may improve cardiovascular outcomes, interventions designed to target the effects of circadian misalignment on blood pressure regulation are warranted. [ABSTRACT FROM AUTHOR]

Eicosapentaenoic acid (EPA) is an omega-3 fatty acid found in fatty fish and fish oil supplements. Over the past few decades, research has suggested that EPA has various potential health benefits, particularly for heart health. EPA has been associated with reduced inflammation, improved cholesterol levels, and reduced blood pressure, all of which can contribute to a lower risk of heart disease. Additionally, EPA has been found to reduce the risk of blood clots, which can lead to heart attacks and strokes. This comprehensive review article aims to summarize the current state of knowledge regarding the potential health benefits of EPA. We focus on its effects on cardiovascular health, inflammation, atherosclerotic plaques, blood clots, diabetes, obesity, and cancer. Finally, we provide an overview of the recommended daily dose of EPA for optimal health benefits. This review highlights the importance of EPA in promoting overall health and well-being and provides insights into its potential therapeutic applications. [ABSTRACT FROM AUTHOR]

Ethylene oxide (EtO) is a widely used industrial chemical with recognized health risks. While its carcinogenic properties have been extensively studied, emerging evidence suggests potential associations with cardiovascular diseases. Using the recently introduced Life's Essential 8 (LE8) score as a comprehensive cardiovascular health (CVH) measure, this study aimed to elucidate the relationship between EtO exposure and CVH. Data from the National Health and Nutrition Examination Survey (NHANES) encompassing 3748 adults was analyzed. CVH was assessed using the LE8 score, which incorporates diet, physical activity, tobacco/nicotine exposure, sleep duration, BMI, non-HDL cholesterol, blood glucose, and blood pressure. The association between EtO exposure, gauged by Hemoglobin adduct (HbEtO) levels, and CVH was examined using linear regression and Cox regression models. An inverse relationship between EtO exposure and the overall CVH score was identified. Specifically, for every 1-unit increase in ln-transformed HbEtO, a 3.69-point decrease in the total CVH score was observed. An inverted J-shaped association between ln-transformed HbEtO and CVH score emerged, with an inflection point at 3.15 pmol/g Hb. Elevated EtO exposure was not significantly linked to all-cause mortality but was robustly associated with increased cardiovascular mortality. Elevated EtO exposure is negatively associated with CVH, as outlined by the LE8 metrics. Beyond a certain threshold, this association underscores the cardiovascular risks of EtO exposure and highlights the importance of further research to determine underlying mechanisms and recommend preventive strategies. [ABSTRACT FROM AUTHOR]

Evidence suggests that Mexican adults living in Mexico have a more favorable cardiovascular risk profile than Mexican adults living in the U.S. However, this relationship has not been evaluated among patients with chronic kidney disease (CKD), which is a question of importance given the high risk for cardiovascular disease among patients with CKD. Using data from two ongoing observational cohort studies, we compared the prevalence of ideal cardiovascular health metrics (assessed by the American Heart Association "Life's Simple 7" criteria) in 309 Mexican adults with CKD living in Mexico City to 343 Mexican adults with CKD living in Chicago. Mexican adults with CKD living in Mexico City had a significantly higher prevalence of ideal body mass index (25 vs. 10%), diet (17 vs. 8%), total cholesterol (80 vs. 63%), blood pressure (43 vs. 25%), and fasting glucose (54 vs. 42%). Mexican adults with CKD living in both Mexico City and Chicago had low levels of cardiovascular health scores. Future work is needed to better understand the lower prevalence of ideal cardiovascular health metrics in Chicago as compared to Mexico City. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is a significant risk factor for cardiovascular disease; however, the impact of weight loss on cardiovascular health (CVH) in individuals with specific obesity patterns remains incompletely understood. The objective of our study was to investigate the relationship weight loss percentage and CVH scores across individuals with various obesity patterns. Methods: Our study utilized data from the National Health and Nutrition Examination Survey conducted between 2007 and 2018, involving a total of 12,835 participants aged 16 years or older, to conduct a cross-sectional analysis. Multiple linear regression and multinomial logistic regression methods were used to assess the correlation between the weight loss percentage and the CVH scores. Additionally, restricted cubic spline analysis was employed to examine the nonlinear relationship between the two variables. Results: Compared to individuals with a weight loss percentage < 0%, participants with weight loss percentages of 0–5% and 5.1–10% showed improved CVH scores, with β values of 2.85 (95% CI 2.32–3.38) and 2.55 (95% CI 1.69–3.4), respectively. Regarding different obesity patterns, compared to participants with a weight loss percentage < 0%, participants with a weight loss percentage of 0–5% showed an increase in CVH scores in the normal weight and overweight/general obesity (OGO) groups, with β values of 1.45 (95% CI 0.7–2.19) and 1.22 (95% CI 0.46–1.97), respectively. Restricted cubic spline analysis revealed a significant inverted U-shaped relationship between the weight loss percentage and the CVH scores (with optimal CVH scores at 3%). Conclusions: There was an inverted U-shaped relationship between weight loss percentage and CVH scores, with moderate weight loss (0–10%, optimal value of 3%) being associated with improved CVH scores, especially among individuals with OGO. Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the association between occupational physical activity (OPA) and resting blood pressure in a cohort of Swedish construction workers. Methods: The final sample included 241,176 male construction workers. Occupations with low OPA were foremen and white-collar workers. The most frequent occupations in the medium OPA group were electricians, pipe workers, and machine operators, and in the high OPA group woodworkers, concrete workers, and painters. Results: Mixed effects models showed higher systolic and lower diastolic blood pressure with higher OPA, but the associations varied depending on the year of participation and participant age as shown by significant interaction terms (OPA*age, OPA*calendar year, age*calendar year). Age-stratified linear regression analyses showed a pattern of slightly higher systolic (1.49, 95% confidence interval: 1.08–1.90 mmHg) and lower diastolic (0.89, 95% confidence interval: 0.65–1.13 mmHg) blood pressure when comparing low with high OPA, but not among the oldest age groups. Conclusion: Despite a rather large contrast in OPA, the differences in systolic and diastolic blood pressure according to OPA were small. [ABSTRACT FROM AUTHOR]

Purpose of Review: In this review, we present a comprehensive discussion on the population-level implications of digital health interventions (DHIs) to improve cardiovascular health (CVH) through sex- and gender-specific prevention strategies among women. Recent Findings: Over the past 30 years, there have been significant advancements in the diagnosis and treatment of cardiovascular diseases, a leading cause of morbidity and mortality among men and women worldwide. However, women are often underdiagnosed, undertreated, and underrepresented in cardiovascular clinical trials, which all contribute to disparities within this population. One approach to address this is through DHIs, particularly among racial and ethnic minoritized groups. Implementation of telemedicine has shown promise in increasing adherence to healthcare visits, improving BP monitoring, weight control, physical activity, and the adoption of healthy behaviors. Furthermore, the use of mobile health applications facilitated by smart devices, wearables, and other eHealth (defined as electronically delivered health services) modalities has also promoted CVH among women in general, as well as during pregnancy and the postpartum period. Overall, utilizing a digital health approach for healthcare delivery, decentralized clinical trials, and incorporation into daily lifestyle activities has the potential to improve CVH among women by mitigating geographical, structural, and financial barriers to care. Summary: Leveraging digital technologies and strategies introduces novel methods to address sex- and gender-specific health and healthcare disparities and improve the quality of care provided to women. However, it is imperative to be mindful of the digital divide in specific populations, which may hinder accessibility to these novel technologies and inadvertently widen preexisting inequities. [ABSTRACT FROM AUTHOR]

Purpose: Diet pattern (DP) is a key modifiable and cost-effective factor in hypertension (HTN) management. The current study aimed to identify and compare the hypertension-protective DPs among Chinese adults. Methods: 52,648 participants aged over 18 years were included from China Nutrition and Health Surveillance (CNHS) 2015–2017. Reduced rank regression (RRR) and partial least square regression (PLS) was applied to identify the DPs. Multivariable-adjusted logistic regression was used to assess the association between the DPs and HTN. Results: DPs derived by RRR and PLS were both featured by higher consumption of fresh vegetables and fruits, mushrooms and edible fungi, seaweeds, soybeans and related products, mixed legumes, dairy products, fresh eggs, and lower of refined grain consumption. Compared to the lowest quintile, participants in the highest quintile had lower odds of HTN (RRR-DP: OR = 0.77, 95% CI = 0.72–0.83; PLS-DP: OR = 0.76, 95% CI = 0.71–0.82; all p < 0.0001). Simplified DP scores were observed the same protective tendencies (Simplified RRR-DP: OR = 0.81, 95% CI = 0.75–0.87; Simplified PLS-DP: OR = 0.79, 95% CI = 0.74–0.85; all p < 0.0001) and showed effective extrapolation in subgroups defined by gender, age, location, lifestyle, and different metabolic conditions. Conclusions: The identified DPs had high conformity with East Asian dietary habits, and significantly negative associations with HTN among Chinese adults. The simplified DP technique also indicated the potential for improving the extrapolation of the results of DP analysis related to HTN. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review summarizes approaches towards neighborhood characterization in relation to cardiovascular health; contemporary investigations relating neighborhood factors to cardiovascular risk and disease; and initiatives to support community-based interventions to address neighborhood-based social determinants related to cardiovascular health. Recent Findings: Neighborhoods may be characterized by Census-derived measures, geospatial data, historical databases, and metrics that incorporate data from electronic medical records and health information exchange databases. Current research has examined neighborhood determinants spanning racial segregation, access to healthcare and food, educational opportunities, physical and built environment, and social environment, and their relations to cardiovascular health and associated outcomes. Community-based interventions have potential to alleviate health disparities but remain limited by implementation challenges. Summary: Consideration of neighborhood context is essential in the design of interventions to prevent cardiovascular disease (CVD) and promote health equity. Partnership with community stakeholders may enhance implementation of programs addressing neighborhood-based health determinants. [ABSTRACT FROM AUTHOR]

Two separate bodies of literature point to the link between family bereavement and cardiovascular health and between sleep quality and cardiovascular outcomes. However, less is known about the joint influence of family bereavement and sleep quality on cardiovascular functioning. The aims of this study were to examine the relationships between experiencing the death of a family member and heart rate variability (HRV) and to further explore whether these associations differ by sleep quality. Using data from the Midlife in the United States (MIDUS) Biomarker Project, the sample for this study included respondents who experienced the death of an immediate family member – father, mother, spouse, sibling, or child – within a year before the Biomarker project and those who did not experience any deaths (N = 962). We used two measures of HRV and sleep quality was measured using the Pittsburgh Sleep Quality Index. Results showed that experiencing the death of a family member was associated with worse HRV only among those with poor sleep quality and not for those with good sleep quality. These results suggest that poor sleep quality may indicate psychophysiological vulnerability for those who experienced the death of a family member. Interventions to improve sleep quality could be effective in enhancing cardiovascular health of bereaved individuals. [ABSTRACT FROM AUTHOR]

Purpose of the Review: Family meals represent a novel strategy for improving cardiovascular health in youth. The purpose of this paper is to describe the association between family meals, dietary patterns, and weight status in youth. Review Findings: According to the American Heart Association's Life's Essential 8, poor diet quality and overweight/obesity status are key contributors to suboptimal cardiovascular health. Current literature highlights a positive correlation between the number of family meals and healthier eating patterns, including greater consumption of fruits and vegetables, and a reduced risk of obesity in youth. However, to date, the role of family meals in improving cardiovascular health in youth has been largely observational and prospective studies are needed to assess causality. Summary: Family meals may be an effective strategy for improved dietary patterns and weight status in youth. [ABSTRACT FROM AUTHOR]

Sweet has always been a fundamental human taste, and while glucose and other kinds of sugar are our primary energy sources, they can also have detrimental effects on health, including weight gain, obesity, cardiovascular diseases, diabetes, and other metabolic diseases. Artificial sweeteners (AS), introduced as sugar substitutes, are a group of chemical compounds that attribute sweetness with almost zero calories and are considered safe for consumption by the Food and Drug Administration (FDA). Although they may help restrict the daily caloric intake of sugar to less than 10% of the daily caloric intake, there are still questions about the long-term safety of AS. A higher risk of hypertension, insulin resistance, high blood sugar, abdominal obesity, and dyslipidemia has been linked to AS. The effect of AS on the cardiovascular system is still unclear, and further research is required. This review examines the potential mechanism of how artificial sweeteners cause cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Stroke remains one of the leading causes of mortality and long-term and permanent disability worldwide despite technological innovations and developments in pharmacotherapy. In the last few decades, the growing data have evidenced the role of the circadian system in brain vulnerability to damage, the development and evolution of stroke, and short-term and long-term recovery. On the other hand, the stroke itself can affect the circadian system via direct injury of specific brain structures involved in circadian regulation (i.e., hypothalamus, retinohypothalamic tracts, etc.) and impairment of endogenous regulatory mechanisms, metabolic derangement, and a neurogenic inflammatory response in acute stroke. Moreover, the disruption of circadian rhythms can occur or exacerbate as a result of exogenous factors related to hospitalization itself, the conditions in the intensive care unit and the ward (light, noise, etc.), medication (sedatives and hypnotics), and loss of external factors entraining the circadian rhythms. In the acute phase of stroke, patients demonstrate abnormal circadian variations in circadian biomarkers (melatonin, cortisol), core body temperature, and rest–activity patterns. The approaches aimed at the restoration of disrupted circadian patterns include pharmacological (melatonin supplementation) and non-medication (bright light therapy, shifting feeding schedules, etc.) interventions; however, their effects on short- and long-term recovery after stroke are not well understood. [ABSTRACT FROM AUTHOR]

Objectives: Whether cardiovascular health (CVH) metrics impact longevity with and without cardiovascular diseases (CVDs) has not been well established. This study aimed to investigate the association between CVH metrics and life expectancy in participants free of CVD events. We hypothesized that ideal CVH status was associated with increased life expectancy and assessed the effect of CVH status as a prevention target of longevity in the framework of predictive, preventive, and personalized medicine (PPPM/3PM). Methods: A total of 92,795 participants in the Kailuan study were examined and thereafter followed up until 2020. We considered three transitions (from non-CVD events to incident CVD events, from non-CVD events to mortality, and from CVD events to mortality). The multistate lifetable method was applied to estimate the life expectancy. Results: During a median follow-up of 13 years, 12,541 (13.51%) deaths occurred. Compared with poor CVH, ideal CVH attenuated the risk of incident CVD events and mortality without CVD events by approximately 58% and 27%, respectively. Women with ideal CVH at age 35 had a 5.00 (3.23–6.77) year longer life expectancy free of CVD events than did women with poor CVH metrics. Among men, ideal CVH was associated with a 6.74 (5.55–7.93) year longer life expectancy free of CVD events. Conclusion: An ideal CVH status is associated with a lower risk of premature mortality and a longer life expectancy, either in the general population or in CVD patients, which are cost-effective ways for personalized medicine of potential CVD patients. Our findings suggest that the promotion of a higher CVH score or ideal CVH status would result in reduced burdens of CVD events and extended disease-free life expectancy, which offered an accurate prediction for primary care following the concept of PPPM/3PM. [ABSTRACT FROM AUTHOR]

Background: Risk factor management is crucial in the management of atrial fibrillation (AF). We investigated the association of changes in cardiovascular health (CVH) levels after AF diagnosis with incident cardiovascular events and mortality. Methods: From the Korea National Health Insurance Service database, 76,628 patients newly diagnosed with AF (2005–2015) with information on health examinations before and after AF diagnosis were assessed. According to the change in the 12-point CVH score before and after AF diagnosis, patients were stratified into four groups: consistently low (score 0–7 to 0–7), high-to-low (8–12 to 0–7), low-to-high (0–7 to 8–12), and consistently high (8–12 to 8–12) CVH levels. Risks of cardiovascular events and death were analyzed using weighted Cox regression models with inverse probability of treatment weighting (IPTW) for balance across study groups. Results: The mean age of study participants was 58.3 years, 50,285 were men (63.1%), and the mean follow-up was 5.5 years. After IPTW, low-to-high (hazard ratio [95% confidence interval], 0.83 [0.76–0.92]) and consistently high (0.80 [0.74–0.87]) CVH levels were associated with a lower risk of ischemic stroke than consistently low CVH. Low-to-high (0.66 [0.52–0.84]) and consistently high (0.52 [0.42–0.64]) CVH levels were associated with a lower risk of acute myocardial infarction. Maintaining high CVH was associated with reduced risks of heart failure hospitalization (0.85 [0.75–0.95]) and all-cause death (0.82 [0.77–0.88]), respectively, compared with consistently low CVH. Conclusions: Improving CVH levels and maintaining high CVH levels after AF diagnosis is associated with lower risks of subsequent cardiovascular events and mortality. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the effect of dietary consumption of olive pomace oil (OPO) on blood lipids (primary outcome) and other cardiovascular disease (CVD) risk factors (blood pressure, inflammation and endothelial function as secondary outcomes). Methods: A randomized, controlled, blind, crossover intervention was carried out in healthy and at-risk (hypercholesterolemic) subjects. Participants consumed daily 45 g of OPO or high-oleic acid sunflower oil (HOSO) as control oil during 4 weeks. Results: OPO significantly reduced low-density lipoprotein cholesterol (LDL-C; P = 0.003) and apolipoprotein B (Apo B; P = 0.022) serum concentrations, and LDL/HDL ratio (P = 0.027) in healthy and at-risk volunteers. These effects were not observed with HOSO. Blood pressure, peripheral artery tonometry (PAT), endothelial function and inflammation biomarkers were not affected. Conclusions: Regular consumption of OPO in the diet could have hypolipidemic actions in subjects at cardiovascular risk as well as in healthy consumers, contributing to CVD prevention. Clinical trial registry: NCT04997122, August 8, 2021, retrospectively registered. [ABSTRACT FROM AUTHOR]

Healthy lifestyle behaviors play a significant role in promoting cardiovascular health. Primary care clinicians (PCCs) are tasked with promoting cardiovascular health through the assessment of lifestyle behaviors and the use of behavior change counseling. However, PCCs face several barriers including a lack of training in counseling techniques. We propose a framework to guide the development of a patient-centered digital communication bundle that can aid PCCs in helping their patients create and sustain feasible lifestyle changes. Our framework proposes that this digital communication bundle contains the following features: assess and analyze an individual’s cardiovascular health status; communicate personalized information in a health-literacy-friendly, visual format; assess behavioral components of change (e.g., motivation) that can inform the PCC’s approach in guiding behavior change; provide PCCs with brief, behavior change counseling prompts that are grounded in motivational interviewing; and assess and address potential structural, socioeconomic, and environmental barriers, thereby fostering resilience in patients’ lifestyle change efforts. We highlight the available research to support the need for such a tool and its potential ability to guide PCCs while also promoting behavior change in a patient-centered manner. [ABSTRACT FROM AUTHOR]