Search

The efficacy, safety, and utility of Nigella sativa seeds oil as a complementary treatment for hypertension, glucose control, and lipid metabolism were evaluated. Hypertensive patients in the intervention (n = 26) and placebo (n = 29) groups received 2.5 ml of N. sativa seeds oil and sunflower oil twice daily for 8 weeks, respectively. The levels of systolic and diastolic blood pressure (SBP, DBP), blood lipid profile, and fasting blood sugar (FBS), at different stages of the treatment period (0, 3, 6, 8 weeks), and malondialdehyde (MDA) and glutathione reductase (GR), at the baseline and end of the study, were assessed. SBP level in the intervention group was significantly reduced, compared with the baseline values (p < .001) and the placebo group (p < .05). A significant decline was observed in the levels of DBP, total cholesterols, and low density lipoprotein (LDL) (p < .000), MDA, and FBS (p < .001); also, a significant increase was observed in the levels of high density lipoprotein (HDL) and GR (p < .001). The use of N. sativa seeds oil as an adjunct to common medications exhibited additional antihypertensive effects as well as beneficial effects on glucose control and lipid metabolism in hypertensive patients with no renal, hepatic, and patient-reported adverse events.

The dietary inflammatory index (DII) is a novel way of describing diet that has been studied in relation to various health conditions, including cardiovascular disease (CVD) in several populations. We aimed to investigate the association between DII and CVD events among a representative population sample in northeastern Iran. This prospective cohort study was a subsample of 4,672 adults aged 35-65 years, and recruited as part of Mashhad stroke and heart atherosclerotic disorder cohort study population. The DII was computed at baseline according to a 65-item validated food frequency questionnaire. Cox regression was used to determine the association of DII with incident CVD. One hundred twenty-four participants developed CVD (including 24 cases of myocardial infarction [MI], 34 cases of stable angina [SA], and 66 cases of unstable angina [UA]). After adjusting for potential confounding factors, a hazard ratios of 1.06 (95% confidence interval: 0.70-1.60), 1.36 (95% confidence interval: 0.52-3.52), 1.33 (95% confidence interval: 0.60-2.94), and 0.86 (95% confidence interval: 0.48-1.53) were found for total CVD, MI, SA, and UA events, respectively, among the participants with proinflammatory diet (DII ≥ 0) versus those with anti-inflammatory diet (DII < 0). There was no statistically significant association between the DII and total CVD, MI, SA, or UA in this population of middle-aged Iranian men and women.

Background: Heat shock protein 27 (HSP27) is an intracellular chaperone constitutively expressed in many cell types including cardio myocytes and endothelial cells. Circulating levels of HSP27 and anti-HSP27 antibody are higher in patients with CVD. Anti-HSP27 antibody concentrations were also reported to be increased in atherogenesis. We aimed to evaluate serum anti-HSP27 antibody titers in individuals with, or without, MetS in the MASHAD study cohort with large sample size in 6,568 subjects. Methods: Participants with MetS were identified from MASHAD cohort (n=3358) using the IDF criteria, and the control group were those individuals who did not meet these criteria (n=3210). In-house enzyme-linked immune sorbent assay (ELISA) method was used for measuring Anti-HSP27 antibody levels. The two groups were matched for age, sex and smoking habit. Results: As expected, there were significant differences in height (p= 0.004), waist and hip circumference, weight, BMI, systolic and diastolic blood pressure, TGs, TC, HDL-C, Hs-CRP, glucose, with the presence of diabetes mellitus, hypertension, hyperlipidemia (p Conclusion: In conclusion, our results revealed serum anti-HSP27 antibody titers were not statistically different between individuals with and without MetS. However, it is possible that drug treatment may affect antibody titers and confound our findings in this population sample..

Background Normal weight obesity (NWO) is defined by a normal body mass index (BMI) but a high percentage body fat (%BF) composition. We aimed to examine the hypothesis that subjects having NWO are at higher risk for cardio metabolic abnormalities compared to normal body weight subjects with low body fat content. Method In this cross sectional study 2439 adults' normal body Mass Index were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. We measured 6 cardio-metabolic risk factors: Low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), systolic and diastolic blood pressure, and serum C-reactive protein (hs-CRP). Two models were evaluated: in model A, the categorization of individuals utilized cut off values of BMI: 18.5–25 and %BF: > 25 in men and >30 in women; in model B, the cut off values used were BMI: 18.5–25 and BF% with cut-offs depending on age: 20–39 years, >19% and >32%; 40–59 years, >21% and 33% and 60–79 years, > 24% and 35% for men and women were used, respectively. Cardiovascular risk estimates were made using QRISK2. SPSS version 18(SPSS Inc. Chicago, IL, USA) was used for all statistical analyses. GraphPad Prism 6 for figures was used. Result Of the 2439 individuals with a normal BMI, 38.5% were found to be in high group and 61.5% were placed in normal weight groups for %BF in model A. In model B, 53.8% and 46.2% were found to be in the normal and high groups for %BF. The odds ratio for the presence of a metabolic abnormality for the high %BF group was 1.82 (95% CI, 1.42–2.34) and for high QRISK was 5.79 (95%CI, 4.17–8.02) after adjusted for age, in model A. In model B, the odds ratio for the presence of a metabolic abnormality for the high %BF group was 2.02 (95% CI, 1.68–2.42) and for high QRISK was 6.03 (95%CI, 4.45–8.08) after adjusted for sex. Conclusion It can be stated that if body fat analysis among normal weight individuals can have an important contribution to the prevention of cardiovascular disease and other obesity-related conditions.

Background The role of dietary patterns in metabolic syndrome has not been investigated sufficiently among Iranian population. The aim of this study is to investigate the association of major dietary patterns with the risk of metabolic syndrome and its components among healthy individuals of Iran. Methods This is a cross-sectional study that was performed on 5895 men and women who participated in MASHAD study project. Factor analysis was employed to determine major dietary patterns with regard to a validated 65-item food frequency questionnaire. Metabolic syndrome was diagnosed using international diabetes federation (IDF). Logistic regression analysis was used to evaluate the association between dietary patterns and metabolic syndrome risk to generate odds ratios (ORs) and 95% confidence intervals (CI). Results Three major dietary patterns (Balanced, Western and high carbohydrate) were identified. The Western pattern showed a positive association with metabolic syndrome (OR [95%CI] for highest vs. lowest tertile: 1.58 [1.21–2.06]; p value = 0.001). The high carbohydrate dietary pattern was associated with higher metabolic syndrome risk (OR [95%CI] for highest vs. lowest tertile: 1.17 [1.02–1.33]; P value = 0.022). The Balanced dietary pattern was unrelated to metabolic syndrome, but was related to some individual risk factors for metabolic syndrome. Conclusions These results suggest that the Western and high carbohydrate patterns are associated with an increased risk for metabolic syndrome among Iranian adults. The causality of these associations needs to be confirmed.

Obesity is an important feature of the metabolic syndrome and is associated with an increased risk of type 2 diabetes mellitus, cardiovascular disease, and some cancers. The aim of this study was to determine the relationship between body fat percentage and an imbalance of the prooxidant/antioxidant balance (PAB), serum superoxide dismutase (SOD1) and inflammation (serum hs-CRP) and increase risk of metabolic syndrome and diabetes mellitus. In this study, 9154 individuals were recruited as part of the Mashhad Stroke and Heart Association Disorder (MASHAD) study. Subjects were categorized into two groups according to body fat percentage as defined >25% in male and > 30% in female, according to gender. Biochemical factors, including serum PAB, SOD1, and hs-CRP were measured in all subjects. SPSS version 18 was used for statistical analyses for all. GraphPad Prism 6 for figures was used. Of total number of subjects (9154), 6748 (73.7%) were found to have a high body fat (BF) percentage. Serum hs-CRP and PAB were significantly higher in individuals with a high BF percentage (P 0.05). BF percentage, serum PAB and serum hs-CRP were significantly higher in individuals with metabolic syndrome and diabetes versus those without metabolic syndrome and diabetes mellitus (P < 0.05), however serum SOD1 was significantly lower in individuals with metabolic syndrome (P < 0.005). Oxidative stress and inflammation are two factors that may link the presence of high BF percentage with the development of metabolic syndrome, diabetes, and cardiovascular disease. © 2018 BioFactors, 45(1):35-42, 2019.

Background and aims: There is persuasive evidence that oxidative stress and inflammation are features of the metabolic syndrome (MetS). We have investigated the relationship between serum pro-oxidant antioxidant balance (PAB), serum uric acid and high sensitive C-reactive protein (hs-CRP) in 7208 participants from the MASHAD study cohort, who were categorized as having MetS, or not, using IDF criteria. Methods: Serum fasting lipid, fasting blood glucose and uric acid concentrations were measured enzymatically using commercial kits on a BT- 3000 autoanalyzer (Biotechnical, Rome, Italy). Serum hs-CRP was measured by PEG-enhanced immunoturbidimetry method using an Alycon analyzer (ABBOTT, Chicago, IL, USA). A colorimetric method was used to determine serum PAB. Results: Serum PAB values were significantly higher in the individuals with MetS compared to those without MetS (p

Objectives\ud The adverse effects of cigarette smoking have been widely studied before, whilst the effects of hookah smoking has received less attention, although it is a common habit in the Middle East. Here we have investigated the effects of cigarette and hookah smoking on biochemical characteristics in a representative population sample derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study, from Northeastern Iran.\ud \ud Study design\ud A total of 9840 subjects from the MASHAD population study were allocated to five groups; non-smokers (6742), ex-smokers (976), cigarette smokers (864), hookah smokers (1067), concomitant cigarette and hookah smokers (41).\ud \ud Methods\ud Baseline characteristics were recorded in a questionnaire. Biochemical characteristics were measured by routine methods. Data were analyzed using SPSS software and p

Background Serum high-sensitive C-reactive protein (hs-CRP) concentrations independently predict the development of diabetes, metabolic syndrome and cardiovascular disease. However, the impact of dietary factors on serum high-sensitive C-reactive protein concentrations in diabetic patients has received limited attention. We aimed to investigate the association between dietary factors and high-sensitive C-reactive protein , among diabetic patients with and without hypertension and healthy subjects. Methods In this cross-sectional study, diabetics with ( n = 325) and without hypertension ( n = 599) and healthy individuals ( n = 1220) were recruited in Mashhad, Iran. Dietary intake was assessed by 24-h recall. Biochemical parameters including serum high-sensitive C-reactive protein were measured using standard protocols. Stepwise multiple regression analysis was used to predict whether serum high-sensitive C-reactive protein concentration was associated with dietary constituents. Results High-sensitive C-reactive protein was significantly higher among hypertensive and non-hypertensive diabetic patients compared with healthy subjects ( P Conclusion Serum high-sensitive C-reactive protein concentrations were found to be a significant predictor for hypertensive and non-hypertensive diabetic subjects. There was a significant association between dietary factors include zinc, iron, sodium and cholesterol and serum high-sensitive C-reactive protein, while there was an inverse association between dietary calcium and serum high-sensitive C-reactive protein in diabetic hypertensive individuals.

Metabolic syndrome is a clustering of metabolic abnormalities that include central obesity, dyslipidemia, insulin resistance, and increased blood pressure. The aim of this study was to evaluate and identify the risk factors associated with metabolic syndrome by using a decision tree algorithm as a data mining tool. A total of 6578 individuals were included in the analysis using a body mass index (BMI) cutoff >= 25 kg/m2 for the definition of overweight, in accordance with International Diabetic Federation (IDF) criteria. Subjects with obesity plus two or more of the criteria for defining metabolic syndrome were included in the metabolic syndrome group. Of the 6578 subjects, 70% (4539 subjects) were selected as a “training” dataset and 30% (2039 cases) were used as the testing dataset to evaluate the performance of decision tree. Two models were evaluated. In model I, age, sex, educational level, marriage and job status, fasted serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), uric acid, fasting blood glucose (FBG), high sensitive C-reactive protein (Hs-CRP), systolic (SBP) and diastolic (DBP) blood pressure, and physical activity level were considered as input variables and in model II, age, gender, Hs-CRP, white blood cell (WBC), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), Platelets (PLT), red cell distribution width (RDW), and platelet distribution width (PDW) were used as input variables. The validation of the model was assessed by constructing a receiver operating characteristic (ROC) curve. The results showed that in model I, serum fasted TG was the most important associated risk factor for metabolic syndrome. In model II, serum Hs-CRP was identified as a risk factor of metabolic syndrome. The sensitivity, specificity, accuracy, and the area under the ROC curve (AUC) values for model I were 99%, 94%, 97% and 0.972 and for model II were 74%, 77%, 76% and 0.812, respectively. Our findings in model I suggest that the IDF criteria are suitable for identifying individuals within the Iranian population into those with, or without MetS. Furthermore, model II showed that serum Hs-CRP concentrations were identified as a risk factor for metabolic syndrome within the Iranian population.

Background The prevalence of metabolic syndrome (MetS) is increasing globally. It is associated with a significant risk of developing type 2 diabetes mellitus and cardiovascular disease. Materials and methods The relationship between adherence to several different dietary patterns and the presence of MetS was explored in an Iranian population sample of 5764 subjects. Results We observed that the prevalence of MetS was 13% and 18% in men and women, respectively. There were three main dietary patterns: the first pattern was characterized by protein, carbohydrate, starch, glucose, fructose, sucrose, maltose, dietary fibre, potassium, calcium, magnesium, phosphorus, iron, zinc, manganese, thiamine, riboflavin, carotene, vitamin c and lactose; second representative of fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, sodium, calcium, zinc, phosphorus, iodine, vitamin D, chloride, betaine, niacin; third consisting of copper, selenium, vitamin A, riboflavin, vitamin B12. In this dietary pattern, individuals in first quintile had a higher consumption of total fat, saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, cholesterol and vitamin A. In the second pattern, individuals in the fifth quintile ate less carbohydrate, dietary fibre, glucose, Fructose, potassium compared to first quintile. We found that individuals in the first quintile in pattern 3 had higher intakes of protein, zinc and calcium compared to other quintiles. Conclusions We have found that a nutrient pattern which mostly characterized by dietary protein, carbohydrate, starch, glucose, fructose, sucrose, maltose was associated with a higher risk of MetS in both genders, while a pattern which was represent of copper, selenium, Vitamin A, riboflavin, vitamin B12 was associated with greater odds of Mets, in women.

Metabolic syndrome (MetS) is characterized by abdominal obesity, dyslipidemia, hypertension and glucose intolerance, and is associated with an increased risk of developing cardiovascular disease (CVD), diabetes mellitus and related diseases. Circulating levels of inflammatory markers such as C-reactive-protein (CRP) have reported to be associated with CVD. Against this background, the prevalence of MetS is increasing globally, and thus predictive biomarkers are required for identification of MetS patients at an increased risk. Here we explored the value of CRP as a biomarker in 7284 subjects and also investigated which features of MetS have the greatest association with the hs-CRP level.The subjects were recruited from the Mashhad stroke and heart atherosclerotic disorder study. Anthropometric factors and biochemical parameters (for example, high-sensitivity CRP (hs-CRP), high-density lipoprotein/low-density lipoprotein, triglycerides (TGs) and fasting blood glucose (FBG)) were determined. Univariate and multivariate analyses were conducted to evaluate the association of hs-CRP and MetS.Our results illustrated that the concentration of serum hs-CRP increased progressively with the number of MetS components, and subjects who fulfilled the criteria of MetS for waist circumference, TGs, blood pressure and FBG were found to have hs-CRP of 0.53, 0.38, 0.34 and 0.71 mg/l, respectively, higher than matched-subjects. Importantly, FBG had the greatest association with hs-CRP concentration.Our data demonstrate the significant association between MetS components with hs-CRP, indicating that this association was cumulative by increasing the number of the defining features of MetS, supporting further studies to explore the value of emerging marker as a novel method for detecting individuals at high risk of developing MetS.

BACKGROUND: Combination of dyslipidemic phenotypes, including elevated plasma levels of low‐density lipoprotein cholesterol (LDL‐C), elevated plasma triglycerides (TG), and decreased low‐density lipoprotein cholesterol (HDL‐C) concentrations, is important because of the association of individual phenotypes with increased risk of cardiovascular disease (CVD). We investigated the prevalence of combined dyslipidemias and their effects on CVD risk in an Iranian large population. METHOD: A total of 9847 individuals were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Anthropometric parameters and biochemical indices were measured in all of the subjects. Different types of combined dyslipidemias including high TG + low HDL‐C, high TG + low HDL‐C + high LDL‐C, low HDL‐C + high LDL‐C, high TG + high LDL‐C, and finally high TG + high LDL‐C + low HDL‐C were considered. Ten‐year CVD risk was calculated using the QRISK2 risk algorithm and adjustments were made as suggested by the Joint British Societies’ (JBS2). Logistic regression analyses were performed to determine the association between different combined dyslipidemias and categorical QRISK. RESULTS: A total of 3952 males and 5895 females were included in this current study. Among the included subjects, 83.4% had one form of dyslipidemia, and 16.6% subjects were not dyslipidemic. The mean age was 48.88 ± 7.9 and 47.02 ± 8.54 years for dyslipidemic and nondyslipidemic groups, respectively. The results showed that the frequency of dyslipidemia was 98%, 87.1%, and 90% in subjects with metabolic syndrome, CVD, and diabetes, respectively. Our results suggested that around 15.7% of study population were at 10 years CVD risk (high ≥20) and it was higher in men than women (P

Methadone is a drug associated with the development of prolonged Correcred QT (QTc) interval, as QT interval prolongation can occur in up to 15% of methadone-maintenance patients. In recent years, methadone found to be associated with an increased risk of sudden death in a community-based study (1, 2). ‘‘Torsades de Pointes’’ is a quick and dangerous rhythm that quickly becomes ventricular fibrillation. If this rhythm is rapid or prolonged, it can lead to ventricular fibrillation or sudden cardiac death. The usual clinical manifestations of TdP are palpitations, dizziness, and syncope. It is certain that no cardiac drugs are recognized to increase the propensity for TdP. The most common risk factors of methadone-associated QT prolongation and TdP include a high dose of methadone or chronic use, old age, accompaniment with enhancing drugs methadone levels, infections such as AIDS, old age, low potassium, kidney failure, heart disease, female gender, and cirrhosis of the liver (3). Despite the availability of methadone for over 60 years, only in the past 10 years has this medication received attention for its potential to cause QTc prolongation leading to Torsades de Pointes (4-6). We report 4 cases of methadone-induced Torsades de pointes. Through rapid taper of methadone, the patient’s ECG normalized.

Background: Diabetes mellitus remains one of the major health problems of the 21st century and is associated with comorbidities including obesity and metabolic abnormalities. The study was conducted to evaluate serum high-sensitivity C-reactive protein (hs-CRP) levels, as a marker of inflammation, in a large sample of Iranian population without a history of cardiovascular or inflammatory disease and cancer, and to relate this to fasting blood glucose (FBG) and the presence of diabetes mellitus. Methods: The study consisted of 7,762 subjects divided into four groups—nonobese/nondiabetic, obese/nondiabetic, nonobese/diabetic and obese/diabetic—based on the BMI classification and their FBG. Anthropometric characteristics were measured and blood was collected for the evaluation of fasted lipid profile, FBG and serum hs-CRP levels. Results: Several clinical and biochemical characteristics were significantly different among the four groups: FBG, P 3 mg/dl had higher TC (P < 0.001), low-density lipoprotein cholesterol (LDL-C, P < 0.001), TG (P < 0.001), fat percentage (P < 0.001), and systolic and diastolic blood pressure (P < 0.001) compared with subjects with a serum hs-CRP

To evaluate the effect of a computerized Decision Support System (CDSS) on improving adherence to an anticoagulation guideline for the treatment of atrial fibrillation (AF). This study had an interrupted time series design. The adherence to the guideline was assessed at fortnightly (two weeks) intervals from January 2016 to January 2017, 6 months before and 6 months after intervention. Newly diagnosed patients with AF were included in the offices of ten cardiologists. Stroke and major bleeding risks were calculated by the CDSS which was implemented via a mobile application. Treatment recommendations based on the guideline were shown to cardiologists. The segmented regression model was used to evaluate the effect of CDSS on level and trend of guideline adherence for the treatment of AF. In our analysis, 373 patients were included. The trend of adherence to the anticoagulation guideline for the treatment of AF was stable in the pre-intervention phase. After the CDSS intervention, mean of the adherence to the guideline significantly increased from 48% to 65.5% (P-value

Background: The high prevalence of cardiovascular disease (CVD) globally is attributable to an interaction between environmental and genetic factors. Gene × diet interaction studies aim to explore how a modifiable factor interacts with genetic predispositions. Here we have explored the interaction of a heat shock protein (HSP70) gene polymorphism (+1267A>G) with dietary intake and their possible association with serum C-reactive protein (CRP), an inflammatory marker, that is a major component of CVD risk.\ud \ud Methods: HSP70 genotype was determined using a TaqMan real time PCR based method. Genetic variation of the HSP70 gene +1267A>G locus. Dietary intake was assessed using a dietary questionnaire. Serum high sensitivity (Hs) CRP and other cardiovascular risk factors were assessed by routine methods. This included coronary angioplasty to determine the presence of coronary artery stenosis. \ud \ud Results: There were significant differences between serum lipid profile and Hs-CRP across the genotypes for Hsp70. The carriers of G allele had higher serum hs-CRP concentrations, compared with the AA homozygotes, with the wild genotype. Interaction analysis showed the association was modulated by total energy intake; the interaction of high energy intake with GG genotype: RERI= 0.77, AP= 0.26, S=1.6.\ud \ud Conclusion: We have found a significant association between the +1267A>G variant of the HSP70 gene with cardiovascular risk factors and serum hs-CRP concentrations. It is possible that a low energy diet could ameliorate the unfavorable effects of G allele of HSP70.

Background: Depression and anxiety are two important mood disorders that are frequently associated with chronic diseases such as cardiovascular diseases (CVDs). Hyper-inflammation is related to both CVDs and psychiatric conditions such as depression and anxiety. Therefore, inflammation may partially explain the relationship between depression and cardiovascular disease.\ud \ud Objective: The objective of this study was to investigate the association between symptoms of depression/anxiety disorders and serum hs-CRP and inflammation linked conditions in a large Iranian population. \ud Methods: Symptoms of depression and anxiety disorders and serum hs-CRP levels were measured in 9,759 participants (40% males and 60% females) enrolled in MASHAD study. Symptoms of depression and anxiety were evaluated with Beck Depression and Anxiety Inventories. According to the scores of depression and anxiety, individuals were categorized into four groups of no or minimal, low, moderate and severe categories.\ud \ud Results: The median serum hs-CRP concentration increased with increasing severity of depression and anxiety disorders. Male participants with severe depression had significantly higher levels of hs-CRP (p

Background Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. Objective The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. Materials and Methods A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects. Univariate and multivariate logistic regression analysis were performed to determine the association of biochemical and hematological parameters with HTN. Results Several biochemical parameters including fasting plasma glucose (FBG), serum high-sensitivity C-reactive protein (hs-CRP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and uric acid were increased in hypertensive participants. In contrast, serum high-density lipoprotein cholesterol (HDL-C) was lower in hypertensive individuals. Furthermore, we demonstrated that hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), and mean corpuscular hemoglobin (MCH) were higher in the hypertensive group compared to the control group. But mean corpuscular volume (MCV), and red cell distribution width (RDW), were decreased in the hypertensive group. Furthermore, our results strongly suggested that among these parameters, hematocrit was the independent risk factor for hypertension in the population. Conclusion We demonstrated the association of altered biochemical and hematological factors with hypertension supporting the value of emerging markers for early prediction of high blood pressure in prone individuals.

Background: Potential role of computerized decision support system on management of atrial fibrillation is not well understood. Objectives: To systematically review studies that evaluate the effects of computerized decision support systems and decision aids on aspects pertaining to atrial fibrillation. Data sources: We searched Medline, Scopus and Cochrane database. Last date of search was 2016, January 10. Selection criteria: Computerized decision support systems that help manage atrial fibrillation and decision aids that provide useful knowledge for patients with atrial fibrillation and help them to self-care. Data collection and analysis: Two reviewers extracted data and summarized findings. Due to heterogeneity, meta-analysis was not feasible; mean differences of outcomes and confidence intervals for a difference between two Means were reported. Results: Seven eligible studies were included in the final review. There were one observational study without controls, three observational studies with controls, one Non-Randomized Controlled Trial and two Randomized Controlled Trials. The interventions were three decision aids that were used by patients and four computerized decision support systems. Main outcomes of studies were: stroke events and major bleeding (one article), Changing doctor-nurse behavior (three articles), Time in therapeutic International Normalized Ratio range (one article), decision conflict scale (two articles), patient knowledge and anxiety about stroke and bleeding (two articles). Conclusions: A computerized decision support system may decrease decision conflict and increase knowledge of patients with atrial fibrillation (AF) about risks of AF and AF treatments. Effect of computerized decision support system on outcomes such as changing doctor-nurse behavior, anxiety about stroke and bleeding and stroke events could not be shown.We need more studies to evaluate the role of computerized decision support system in patients with atrial fibrillation.

Depression and anxiety are two important mood disorders that are frequently associated with chronic diseases such as cardiovascular diseases (CVDs). Hyper-inflammation is related to both CVDs and psychological conditions such as depression and anxiety. Therefore, inflammation may partially explain the relationship between depression and cardiovascular disease.The objective of this study was to perform a gender-stratified examination of the association between symptoms of depression/anxiety disorders and serum hs-CRP and inflammation linked conditions in a large Iranian population.Symptoms of depression and anxiety disorders and serum hs-CRP levels were measured in 9759 participants (40% males and 60% females) aged 35-65 years, enrolled in a population-based cohort (MASHAD) study in north-eastern Iran. Symptoms of depression and anxiety were evaluated with Beck Depression and Anxiety Inventories. According to the scores of depression and anxiety, individuals were categorized into four groups of no or minimal, low, moderate and severe categories.The median serum hs-CRP concentration increased with increasing severity of depression and anxiety disorders. Male participants with severe depression had significantly higher levels of hs-CRP (p0.001); however, this relationship was less marked among women (p=0.04). Subjects with severe anxiety also had significantly higher levels of hs-CRP (p0.001). Moreover, women with severe depression and anxiety had higher BMI. There was also a positive association between current smoking habit and depression/anxiety disorders.Depression and anxiety disorders are associated with elevated levels of hs-CRP, particularly among men. Also, there is a significant positive association between depression/anxiety disorders and inflammation linked conditions such as smoking and obesity; however, in the case of obesity this association is only present in women.

Background Metabolic syndrome is defined by a clustering of cardiovascular risk factors and is associated with a heightened inflammatory state. A raised serum high-sensitivity C-reactive protein, a marker of inflammation, is also known to associate with cardiovascular risk. We have investigated the relationship between the presence of metabolic syndrome and serum high-sensitivity C-reactive protein concentration in a large representative Persian population cohort without a history of cardiovascular disease. Methods The MASHAD study population cohort comprised 9778 subjects, who were recruited from the city of Mashhad, Iran, between 2007 and 2008. Several cardiovascular risk factors were measured in this population without cardiovascular disease. Individuals were categorized into quartiles of serum high-sensitivity C-reactive protein concentration: first quartile – 0.72 (0.59–0.85) (median [range]) mg/L, second quartile – 1.30 (1.14–1.4) mg/L, third quartile – 2.29 (1.92–2.81) mg/L and fourth quartile – 6.63 (4.61–11.95) mg/L, respectively. The prevalence of metabolic syndrome in each quartile was determined using either International Diabetes Federation or Adult Treatment Panel III criteria. Results The prevalence of metabolic syndrome was highest in the fourth quartile for serum high-sensitivity C-reactive protein (1220 subjects [50.0%]), and significantly higher than that in the first quartile (reference group) (634 subjects [25.9%]) ( P Conclusions There was a significant association between high concentrations of serum high-sensitivity C-reactive protein and the presence of metabolic syndrome among individuals without a history of cardiovascular disease in our Persian cohort.

Raised blood pressure is a leading cause of morbidity and mortality worldwide; improved nutritional approaches to population-wide prevention are required.We aimed to investigate the relationship between dietary intake and other cardiovascular risk factors with blood pressure in individuals without a history of a cardiovascular event in an Iranian cohort.A cross-sectional study of 5670 healthy subjects [approximately 40% (n=2179) males and 60% (n=3491) females] was undertaken in a sample from northeastern Iran. Subjects were recruited from an urban population, using a stratified-cluster method and derived from the Mashhad Stroke Heart Atherosclerosis Disorder (MASHAD) study, Mashhad, Iran. The age of the subjects was between 35 and 64 years. None of the subjects had a past history of major disease.The mean ages for the male and female subgroups were 50.1± 8.1years and 48.2 ±7.8 y respectively. Not unexpectedly, subjects without hypertension (HTN) were younger than those with established HTN. Individuals with HTN were significantly more adipose than those without (p0.01). We found no significant differences in crude or total energy adjusted intake of nutrients between the three groups (p0.05), except for crude and energy adjusted phosphorus intake (p0.05) and crude intake of the cholesterol (p0.05). There was a significant correlation between the dietary intake of total fatty acids, phosphorus and vitamin E with both systolic blood pressure (SBP) and diastolic blood pressure (DBP). PUFA (odds ratio [OR] [95% confidence interval (CI)], 1.56 [1.05-1.06]; P0.01), sodium (OR [95% CI], 1.00 [(1.00-1.01)]; P0.01) and phosphorus (OR [95% CI], 1.00 [(1.00-1.01)]; P0.01)were significant independent predictors of HTN after adjustment for energy intake.In our representative population from North-Eastern Iran, it appears that in adults without a history of cardiovascular disease, crude or energy adjusted intake of phosphorus and total fatty acid intake were significant determinants of BP, however we found no association between sodium and potassium intake with BP.

Cold exposure stimulates energy expenditure and glucose disposal. If these factors play a significant role in whole body energy balance, and glucose homeostasis, it is predicted that both obesity and type 2 diabetes prevalence would be lower where it is colder. Previous studies have noted connections between ambient temperature and obesity, but the direction of the effect is confused. No previous studies have explored the link of type 2 diabetes to ambient temperature. We used county level data for obesity and diabetes prevalence across the mainland USA and matched this to county level ambient temperature data. Average ambient temperature explained 5.7% of the spatial variation in obesity and 29.6% of the spatial variation in type 2 diabetes prevalence. Correcting the type 2 diabetes data for the effect of obesity reduced the explained variation to 26.8%. Even when correcting for obesity, poverty and race, ambient temperature explained 12.4% of the variation in the prevalence of type 2 diabetes, and this significant effect remained when latitude was entered into the model as a predictor. When obesity prevalence was corrected for poverty and race the significant effect of temperature disappeared. Enhancing energy expenditure by cold exposure will likely not impact obesity significantly, but may be useful to combat type 2 diabetes.

The objective of this study was to investigate whether serum high-sensitivity C-reactive protein (hs-CRP) concentration varies with dietary fatty acid intake in Iranian adults free of any history of cardiovascular disease (CVD). This cross-sectional study involved 8105 adults (3142 men) aged 35-65 years. Dietary intake was assessed using 24-h dietary recalls. The relationship between anthropometric, cardiometabolic risk factors and dietary data and serum hs-CRP was assessed using SPSS software. Median crude dietary saturated fat decreased across hs-CRP quarters (P =0.009 for linear trend), whereas energy-adjusted total fat (P =0.017), trans-fat (P =0.016), monounsaturated fatty acids (P =0.030) and cholesterol (P =0.005) monotonically increased, with some evidence of statistical interactions by gender. In conclusion, serum hs-CRP concentrations were associated with some components of dietary fatty acid intake in our population of individuals without CVD, suggesting that dietary fat intake could be associated with subclinical inflammation.

Increased pro-Oxidant– Antioxidant Balance in Patients with Diabetes Mellitus Background: Diabetes mellitus (DM) is a common metabolic condition affecting populations globally. Diabetes mellitus is associated with an imbalance between pro-oxidant mechanisms and the antioxidant defenses, contributing to oxidative-stress, and this is associated with an increased susceptibility to endothelial dysfunction, atherosclerosis, insulin-resistance and impairedpancreatic β-cell function. Here we have investigated the serum pro-oxidant/antioxidant balance (PAB) in the patients with diabetes and healthy subjects. Methods: Serum PAB was assessed in 658 subjects, comprised of 69 patients with diabetes, 81 subjects with impaired fasting glucose (IFG) and 508 healthy-subjects. Results: The diabetic patients had significantly higher fasting blood glucose (FBG) and serum triglycerides (TG), compared to subjects with IGT IFG and healthy individuals. Median serum PAB values were significantly higher in the patients with diabetes (92.03 [interquartile-range [IQ]: 31.40-124.56]) compared to the healthy group (48.1 [IQ: 20.6-85.9]; P