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High levels of lipoprotein(a) [Lp(a)] are causal for atherosclerotic cardiovascular disease (ASCVD). Lp(a) is the most prevalent inherited dyslipidemia and strongest genetic ASCVD risk factor. This risk persists in the presence of at target, guideline-recommended, LDL-C levels and adherence to lifestyle modifications. Epidemiological and genetic evidence supporting its causal role in ASCVD and calcific aortic stenosis continues to accumulate, although various facets regarding Lp(a) biology (genetics, pathophysiology, and expression across race/ethnic groups) are not yet fully understood. The evolving nature of clinical guidelines and consensus statements recommending universal measurements of Lp(a) and the scientific data supporting its role in multiple disease states reinforce the clinical merit to start population screening for Lp(a) now. There is a current gap in the implementation of recommendations for primary and secondary cardiovascular disease (CVD) prevention in those with high Lp(a), in part due to a lack of protocols for management strategies. Importantly, targeted apolipoprotein(a) [apo(a)]-lowering therapies that reduce Lp(a) levels in patients with high Lp(a) are in phase 3 clinical development. This review focuses on the identification and clinical management of patients with high Lp(a). Specifically, we highlight the clinical value of measuring Lp(a) and its use in determining Lp(a)-associated CVD risk by providing actionable guidance, based on scientific knowledge, that can be utilized now to mitigate risk caused by high Lp(a).

BACKGROUND: The reference intervals (RIs) of adult blood lipid parameters currently used in China are not derived from the results of research in local populations and have not been adjusted for age and sex. In this study, we aimed to determine accurate RIs for blood lipid parameters and blood glucose (GluG) for Chinese adults using a national multicenter study. METHODS: A total of 11,333 adults between 18 and 90 years of age were recruited in seven representative regions in China between June 2020 and December 2020. Hospitals participating in the study were regrouped into two geographical regions, southern China (Changsha, Chengdu, Hangzhou, and Nanning) and northern China (Beijing, Shenyang, and Ningxia), according to their geographical and administrative location. All samples were freshly collected and measured collectively in one laboratory on the Mindray full Automatic biochemical analyzer chemistry BS2000 analytical systems. Outliers were removed using the Tukey test. Three-level nested analysis of variance and scatter plot were used to explore the variations in sex, age, and region. Percentile curves of each indicator were plotted using the least mean square (LMS) method. The lower limit (2.5th percentile) and the upper limit (97.5th percentile) of the RI were determined by using nonparametric statistical methods. We also calculated the 90% confidence interval (CI) for the lower and upper limits. RESULTS: A total of 8,283 participants were enrolled in the final analysis, with 3,593 (43.4%) men and 4,690 (56.6%) women. Regionality was observed in three analytes [small dense low density lipoprotein cholesterol (sd-LDLC), GluG, and apolipoprotein A1 (ApoA1)]. In northern China, the sd-LDLC and GluG levels in Shenyang were significantly higher than those in Ningxia and Beijing (P55 years, the levels of TG and TC in females gradually surpassed those in males. CONCLUSIONS: The findings of this study may help establish age- and sex-specific reference values for the blood lipids of Chinese adults and serve as a valuable guide for the screening, diagnosis, treatment, prevention, and monitoring of cardiovascular disease (CVD).

BackgroundMethodResultsCardiovascular diseases (CVDs) include abnormal conditions of the heart, diseased blood vessels, structural problems of the heart, and blood clots. Traditionally, CVD has been diagnosed by clinical experts, physicians, and medical specialists, which is expensive, time-consuming, and requires expert intervention. On the other hand, cost-effective digital diagnosis of CVD is now possible because of the emergence of machine learning (ML) and statistical techniques.In this research, extensive studies were carried out to classify CVD via 19 promising ML models. To evaluate the performance and rank the ML models for CVD classification, two benchmark CVD datasets are considered from well-known sources, such as Kaggle and the UCI repository. The results are analysed considering individual datasets and their combination to assess the efficiency and reliability of ML models on the basis of various performance measures, such as precision, kappa, accuracy, recall, and the F1 score. Since some of the ML models are stochastic, we repeated the simulation 50 times for each dataset using each model and applied nonparametric statistical tests to draw decisive conclusions.The nonparametric Friedman – Nemenyi hypothesis test suggests that the Extra Tree Classifier provides statistically superior accuracy and precision compared with all other models. However, the Extreme Gradient Boost (XGBoost) classifier provides statistically superior recall, kappa, and F1 scores compared with those of all the other models. Additionally, the XGBRF classifier achieves a statistically second-best rank in terms of the recall measures. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the relationship between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and the risk of cardiovascular disease (CVD) in middle-aged and elderly Chinese population. CVD has high morbidity and mortality in China, with 5.09 million CVD deaths in 2019 and a mortality rate of 364.5 cases per 100,000 people. Existing studies have focused on specific populations and lack studies on the general population. Methods: This study used data from the China Health and Aged Care Tracking Survey (CHARLS) to analyse the middle-aged and elderly population between 2011 and 2020. The exposure variable was TG/HDL-C ratio, the outcome variable was the occurrence of heart disease (including myocardial infarction, coronary heart disease, etc.), and the covariates included age, gender, education level, and body mass index. The final sample size was 4,551 participants. Weighted Cox regression models were used to assess the association between TG/HDL-C and CVD risk, and nonlinear associations and stratified analyses were performed. Results: The results demonstrated a significant association between TG/HDL-C ratios and cardiac morbidity, with a risk ratio of 0.71 (95% CI: 0.71–0.71) in the adjusted model II. Nonlinear analysis revealed a threshold effect. Within the TG/HDL-C 0.15–1.5 interval (inflection point LnTG/HDL-C 0.41), each 1-unit increase in Ln (TG/HDL-C) was associated with a 17% reduction in the risk. The inflection point was associated with a 0.83-fold reduction in the risk of CVD (95% CI: 0.75, 0.92; p = 0.0003), but beyond this point, the association was no longer significant (1.00-fold reduction in risk; 95% CI: 0.95, 1.05; p = 0.9701). In contrast, stratified analyses demonstrated that the results were more applicable to women and those younger than 65 years. Conclusion: In summary, the study found a significant inverse relationship between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and the risk of cardiovascular disease in the middle-aged and elderly Chinese population, with a nonlinear threshold effect observed at a TG/HDL-C ratio of around 1.5. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: The global burden of cardiovascular diseases is increasing rapidly, and changing trends in epidemiological risk factors are identified among diverse Indian population. There has been a significant increase in heart attack deaths over the past 3 years after the COVID-19 pandemic. Are we missing a link? There is an urgent need for studies to confirm any epidemiological shift in coronary artery disease (CAD) risk factors. Aims and Objectives: To analyse the risk factors in patients with established CAD in rural and urban Indian Kashmiri populations in the post-COVID period. Material and Methods: A prospective observational study of all patients with angiographically proven CAD who have undergone revascularisation or have a clinical suspicion of CAD on the basis of symptoms or positive stress test and later proven to have CAD on coronary angiograms, coming from rural and urban areas of Jammu and Kashmir were enrolled for the study and screened for various modifiable and non-modifiable CAD risk factors. Data was compiled and analysed to know the pattern of various CAD risk factors in our population. Results: The study included total 600 patients (rural and urban 300 each), mean age was 59.13 ± 11.62 years. Male patients were 65.50% with a mean age of 57.53 ± 14.17 years and female patients were 34.50% with a mean age of 62.16 ± 10.02 years. In rural subgroup of 300 patients mean age was 60.99 ± 16.86 years and in the urban population we found a mean age of 57.26 ± 16.21 years. The most common risk factor was smoking in 76% rural and 67% urban. Diabetes (39% rural, 43% urban), dyslipidaemia (47.33%, 48.66% urban), hypertension (61% rural, 66% urban), obesity (23% rural, 29.33% urban) and physical inactivity (33.66% rural, 37.33% urban. Conclusion: CAD manifests earlier in males and urban populations. Smoking is the most common risk factor for CAD in the Kashmiri Indian population and is more common in the rural population. Coronary artery disease risk factors, such as physical inactivity, diabetes, smoking, hypertension, obesity and dyslipidaemia, are more common in the urban population. Preventive strategies should focus on modifying the risk factors to decrease the prevalence of CAD in communities. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) are among the primary causes of mortality globally, highlighting the critical need for early detection to mitigate their impact. Phonocardiograms (PCGs), which record heart sounds, are essential for the non-invasive assessment of cardiac function, enabling the early identification of abnormalities such as murmurs. Particularly in underprivileged regions with high birth rates, the absence of early diagnosis poses a significant public health challenge. In pediatric populations, the analysis of PCG signals is invaluable for detecting abnormal sound waves indicative of congenital and acquired heart diseases, such as septal defects and defective cardiac valves. In the PhysioNet 2022 challenge, the murmur score is a weighted accuracy metric that reflects detection accuracy based on clinical significance. In our research, we proposed a mean teacher method tailored for murmur detection, making full use of the Phyionet2022 and Phyionet2016 PCG datasets, achieving the SOTA (State of Art) performance with a murmur score of 0.82 and an AUC score of 0.90, providing an accessible and high accuracy non-invasive early stage CVD assessment tool, especially for low and middle-income countries (LMICs). [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) represents the leading cause of death worldwide. For individuals at elevated risk for cardiovascular disease, early detection and monitoring of lipid status is imperative. The majority of lipid measurements conducted in hospital settings employ optical detection, which necessitates the use of relatively large-sized detection machines. It is, therefore, necessary to develop point-of-care testing (POCT) for lipoprotein in order to monitor CVD. To enhance the management and surveillance of CVD, this study sought to develop a POCT approach for apolipoprotein B (ApoB) utilizing a shear horizontal surface acoustic wave (SH-SAW) platform to assess the risk of heart disease. The platform employs a reflective SH-SAW sensor to reduce the sensor size and enhance the phase-shifted signals. In this study, the platform was utilized to monitor the impact of a weekly almond and oat milk or statins intervention on alterations in CVD risk. The SH-SAW ApoB test exhibited a linear range of 0 to 212 mg/dL, and a coefficient correlation (R) of 0.9912. Following a four-week intervention period, both the almond and oat milk intervention (−23.3%, p < 0.05) and statin treatment (−53.1%, p < 0.01) were observed to significantly reduce ApoB levels. These findings suggest that the SH-SAW POCT device may prove a valuable tool for monitoring CVD risk, particularly during routine daily or weekly follow-up visits. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) poses a significant challenge to global public health. Dietary intervention therapy offers high cost-effectiveness for treating CVD. Currently, there is limited research on the dietary niacin intake and survival of CVD patients. This study aims to examine the association of dietary niacin intake with long-term survival in people with CVD. Methods: A nationally representative sample of 4,377 diabetes subjects was drawn from the NHANES (National Health and Nutrition Examination Survey) data collected between 2003 and 2018. Dietary niacin intake in this study represents either the average of the two recalls or the value from one recall (if only one recall was available for a participant). Weighted Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs to examine the associations between dietary niacin intake and the risk of all-cause and CVD mortality. Results: After adjustment for multiple covariates, HRs and 95% CIs in model 3 indicated that participants in the highest quartile (Quartile 4) of dietary niacin intake were at lower risk for all-cause mortality (HR = 0.74, 95% CI: 0.60–0.90, P for trend = 0.010) and CVD mortality (HR = 0.67, 95% CI:0.51–0.89, P for trend = 0.020). Conclusion: Higher dietary niacin intake may be associated with a reduced risk of all-cause and cardiovascular disease mortality among CVD patients. Additionally, significant interactions were found between dietary niacin intake and BMI as well as vitamin B12 subgroups. [ABSTRACT FROM AUTHOR]

Calcium (Ca) is a vital nutrient essential for structural development and signal transmission in both plants and animals. In humans, inadequate calcium intake has been correlated with various diseases, including osteoporosis, cardiovascular and cerebrovascular diseases, and cancer. In areas where plants serve as a main dietary source, calcium intake is significantly lower than the recommended adequate intake, notably in low‐ and middle‐income countries (LMICs). Exploring the connections between calcium consumption and cardiovascular disease (CVD) and cancer has significant implications for public health, given that these two conditions are the primary contributors to global mortality. This study conducted a systematic review of existing literature to assess the evidence regarding calcium intake and its effect on blood pressure control, stroke prevention, and the controversial association with myocardial infarction. Furthermore, the preventive effect of calcium intake on tumor development, particularly in cancer prevention, was discussed. The study explores the potential of agronomic biofortification as a key strategy to enhance plant‐based dietary calcium density and improve human health. By advocating for the incorporation of calcium‐rich plants and plant‐derived products, alongside appropriate calcium supplementation, the study emphasizes the economic and practical benefits of plants as a calcium source. This approach is aligned with global dietary patterns and socioeconomic disparities. The review also highlights the need for further research to better understand the mechanisms through which agronomic biofortification can increase dietary calcium intake and reduce the risks of CVD and cancer associated with calcium deficiency. Ultimately, this study aims to deepen our understanding of the complex relationship between calcium intake and health. [ABSTRACT FROM AUTHOR]

Serum uric acid (SUA) has been linked to mortality in heart failure, hypertension, diabetes, hyperlipidemia, obstructive sleep apnea, and metabolic dysfunction-associated fatty liver disease. However, data are lacking on how it affects the mortality risk of patients with cardiovascluar disease (CVD). This study evaluated the data of 4 308 individuals from the National Health and Nutrition Examination Survey 1999–2008 using multivariate Cox proportional hazards regression, trend, restricted cubic splines (RCS), subgroup and inflection point analyses. All-cause and cardiovascular mortality accounted for 42.8% and 17.6% of cases, respectively, over a median 80- month follow-up. Upon control for confounding variables, no linear trend was seen in the Cox proportional hazards regression analysis between SUA and all-cause (P = 0.001) or cardiovascular death (P = 0.007) mortality. On the RCS analysis, SUA showed an L-shaped connection with all-cause (non-linear P < 0.001) and cardiovascular mortality (non-linear P = 0.003) mortality. On the inflection point analysis, patients with CVD and an SUA ≥ 6.127 mg/dL had an all-cause mortality hazard ratio of 1.146 (95% confidence interval, 1.078–1.217; P < 0.001), while those with CVD and an SUA ≥ 5.938 mg/dL had a cardiovascular mortality hazard ratio of 1.123 (95% confidence interval, 1.03–1.225; P = 0.007). In patients with CVD, higher SUA was non-linearly correlated with all-cause and cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, particularly in low- and middle-income countries. Young adults are susceptible to CVD risk factors, especially in developing countries. This study aimed to compare CVD risk factors between medical and non-medical students. Methods: The present cross-sectional study was conducted on a sample of 302 students in Tehran, including 151 medical students and 151 non-medical students, in 2022. Data collection tools included four online questionnaires to collect demographic information, knowledge/attitudes, knowledge of risk factors, and risk factors. Data were analyzed using SPSS version 18 software at a 0.05 significance level. Results: Data analysis revealed that the mean age of medical and non-medical students was 22.06 ± 3.53 and 21.88 ± 4.20 years, respectively. The two groups were not significantly different in gender, age, marital status, and place of residence. Knowledge of CVD was significantly different between the two groups of students (P < 0.001), but attitudes were not significantly different (P = 0.208). A significant difference in the prognosis of diabetes and dyslipidemia was observed between the two groups (P < 0.001). Conclusions: As a large group of young adults in society, students are at risk for CVD. Poor knowledge and inappropriate attitudes regarding CVD risk factors are among the contributing factors. Therefore, it is recommended to design and implement a healthy diet, physical activity, stress management, and healthy lifestyle programs for the young group along with screening programs to prevent complications and mortality caused by CVD. [ABSTRACT FROM AUTHOR]

This article discusses a study conducted in Germany that examines the relationship between regional socioeconomic factors and the use of certain medications for adults with type 2 diabetes. The study finds that individuals in socioeconomically disadvantaged areas have lower access to newer glucose-lowering medications, such as SGLT2 inhibitors and GLP-1RAs. This disparity in access may contribute to socioeconomic disparities in cardiovascular health outcomes. The study suggests that further investigation into structural factors is needed to address these disparities. The study also highlights the importance of raising awareness among healthcare providers and overcoming barriers to access for newer treatment options in order to reduce inequalities. [Extracted from the article]

One of the biggest challenges for the medical professionals is spotting cardiovascular issues in the earliest stages. Around the world, Cardiovascular Diseases (CVD) are a major cause of death for almost 18 million people each year. Heart disease is therefore a serious concern that needs to be treated. The numerous elements that affect health, such as excessive blood pressure, elevated cholesterol, aberrant pulse rate, and many other factors, might make it challenging to detect heart disease. Consequently, early disease detection and the development of effective treatments can benefit greatly from the field of artificial intelligence. The purpose of this work is to develop a new IoT based healthcare monitoring framework for the prediction of CVD using machine learning algorithm. Here, the data preprocessing has been performed to create the normalized dataset for improving classification. Then, an Artificial Gorilla Troop Optimization (AGTO) algorithm is deployed to choose the most pertinent features from the normalized dataset. Moreover, the Multi-Linear Regression Classification (MLRC) model is also implemented for accurately categorizing the medical information as whether healthy or CVD affected. The results of the proposed AGTO-MLRC mechanism is validated and compared using the popular benchmarking datasets. [ABSTRACT FROM AUTHOR]

Background: Ambient ultraviolet radiation (UVR) has been found to have a greater cardioprotective effect than previously believed. This study aimed to quantitatively measure the role of UVR in protecting against the progression of cardiovascular disease (CVD) in general on a global and regional scale. Methods: Population‐level data on UVR, CVD incidence, aging, economic affluence, CVD genetic background (indexed with the Biological State Index, Ibs), obesity prevalence, and urbanization were collected and analysed. The correlation between UVR and CVD was examined using bivariate correlations, partial correlation, and stepwise multiple linear regression. Countries were grouped to investigate regional correlations between UVR and CVD, and Fisher's r‐to‐z transformation was used to compare correlation coefficients. Results: UVR showed a significant inverse correlation with CVD incidence rates in bivariate correlation analyses globally (r = − 0.775 and r = − 0.760, p < 0.001), as well as within high‐income (r = −0.704, p < 0.001) and low‐ and middle‐income countries (LMIC) (r = −0.851, p < 0.001). These correlations remained significant even after controlling for confounding variables (r = −0.689 to −0.812, p < 0.001). In stepwise regression models, UVR was found to be the most significant predictor of CVD incidence. The inverse correlation between UVR and CVD was stronger in LMICs compared to high‐income countries (z = −1.96, p < 0.050). Conclusions: Low ambient UVR may be a significant risk factor for the progression of CVD worldwide. The protective effect of UVR appears to be stronger in LMICs than in high‐income countries, suggesting a greater impact of UVR on CVD prevention in these regions. These findings emphasize the need for further research into the mechanisms underlying the cardioprotective effects of UVR and the development of public health strategies to mitigate CVD risk associated with low UVR exposure. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to investigate the relationship between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and the risk of cardiovascular disease (CVD) in middle-aged and elderly Chinese population. CVD has high morbidity and mortality in China, with 5.09 million CVD deaths in 2019 and a mortality rate of 364.5 cases per 100,000 people. Existing studies have focused on specific populations and lack studies on the general population. Methods This study used data from the China Health and Aged Care Tracking Survey (CHARLS) to analyse the middle-aged and elderly population between 2011 and 2020. The exposure variable was TG/HDL-C ratio, the outcome variable was the occurrence of heart disease (including myocardial infarction, coronary heart disease, etc.), and the covariates included age, gender, education level, and body mass index. The final sample size was 4,551 participants. Weighted Cox regression models were used to assess the association between TG/HDL-C and CVD risk, and nonlinear associations and stratified analyses were performed. Results The results demonstrated a significant association between TG/HDL-C ratios and cardiac morbidity, with a risk ratio of 0.71 (95% CI: 0.71–0.71) in the adjusted model II. Nonlinear analysis revealed a threshold effect. Within the TG/HDL-C 0.15–1.5 interval (inflection point LnTG/HDL-C 0.41), each 1-unit increase in Ln (TG/HDL-C) was associated with a 17% reduction in the risk. The inflection point was associated with a 0.83-fold reduction in the risk of CVD (95% CI: 0.75, 0.92; p = 0.0003), but beyond this point, the association was no longer significant (1.00-fold reduction in risk; 95% CI: 0.95, 1.05; p = 0.9701). In contrast, stratified analyses demonstrated that the results were more applicable to women and those younger than 65 years. Conclusion In summary, the study found a significant inverse relationship between the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and the risk of cardiovascular disease in the middle-aged and elderly Chinese population, with a nonlinear threshold effect observed at a TG/HDL-C ratio of around 1.5.

Abstract Background Cardiovascular disease (CVD) poses a significant challenge to global public health. Dietary intervention therapy offers high cost-effectiveness for treating CVD. Currently, there is limited research on the dietary niacin intake and survival of CVD patients. This study aims to examine the association of dietary niacin intake with long-term survival in people with CVD. Methods A nationally representative sample of 4,377 diabetes subjects was drawn from the NHANES (National Health and Nutrition Examination Survey) data collected between 2003 and 2018. Dietary niacin intake in this study represents either the average of the two recalls or the value from one recall (if only one recall was available for a participant). Weighted Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs to examine the associations between dietary niacin intake and the risk of all-cause and CVD mortality. Results After adjustment for multiple covariates, HRs and 95% CIs in model 3 indicated that participants in the highest quartile (Quartile 4) of dietary niacin intake were at lower risk for all-cause mortality (HR = 0.74, 95% CI: 0.60–0.90, P for trend = 0.010) and CVD mortality (HR = 0.67, 95% CI:0.51–0.89, P for trend = 0.020). Conclusion Higher dietary niacin intake may be associated with a reduced risk of all-cause and cardiovascular disease mortality among CVD patients. Additionally, significant interactions were found between dietary niacin intake and BMI as well as vitamin B12 subgroups.

Abstract Serum uric acid (SUA) has been linked to mortality in heart failure, hypertension, diabetes, hyperlipidemia, obstructive sleep apnea, and metabolic dysfunction-associated fatty liver disease. However, data are lacking on how it affects the mortality risk of patients with cardiovascluar disease (CVD). This study evaluated the data of 4 308 individuals from the National Health and Nutrition Examination Survey 1999–2008 using multivariate Cox proportional hazards regression, trend, restricted cubic splines (RCS), subgroup and inflection point analyses. All-cause and cardiovascular mortality accounted for 42.8% and 17.6% of cases, respectively, over a median 80- month follow-up. Upon control for confounding variables, no linear trend was seen in the Cox proportional hazards regression analysis between SUA and all-cause (P = 0.001) or cardiovascular death (P = 0.007) mortality. On the RCS analysis, SUA showed an L-shaped connection with all-cause (non-linear P

Abstract Background Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, particularly in low- and middle-income countries. Young adults are susceptible to CVD risk factors, especially in developing countries. This study aimed to compare CVD risk factors between medical and non-medical students. Methods The present cross-sectional study was conducted on a sample of 302 students in Tehran, including 151 medical students and 151 non-medical students, in 2022. Data collection tools included four online questionnaires to collect demographic information, knowledge/attitudes, knowledge of risk factors, and risk factors. Data were analyzed using SPSS version 18 software at a 0.05 significance level. Results Data analysis revealed that the mean age of medical and non-medical students was 22.06 ± 3.53 and 21.88 ± 4.20 years, respectively. The two groups were not significantly different in gender, age, marital status, and place of residence. Knowledge of CVD was significantly different between the two groups of students (P

Photoplethysmogram is a noninvasive technique used to detect volumetric changes in the blood. Cardiovascular diseases, related to heart and blood supply problems, are one of the largest causes of death in the world. Our study explored the possibility of classifying different cardiovascular diseases using photoplethysmogram signals for quick diagnosis. Using the support vector machine technique, the classification is done at the software level, while Xilinx Zynq 7000 field-programmable gate array (FPGA) chip is utilized for hardware design. The overall accuracy for detecting cerebral infarction and cerebrovascular disease is 93.48% and 96.43%, respectively, using eleven features. In addition, diabetes which is linked to cardiovascular diseases is classified, and an accuracy of 88.46% is achieved. Considering the PPG signal with a higher signal quality index, the overall accuracy for all the diseases can be further increased. The resource and power utilization of the implemented system is analyzed, which shows that 0.693 W power is required. The developed prototype can be further extended as a point-of-care system for cardiovascular disease detection. [ABSTRACT FROM AUTHOR]

Abstract Background Cardiovascular diseases (CVD) affect over half a billion people worldwide and are the leading cause of global deaths. In particular, due to population aging and worldwide spreading of risk factors, the prevalence of heart failure (HF) is also increasing. HF accounts for approximately 36% of all CVD-related deaths and stands as the foremost cause of hospitalization. Patients affected by CVD or HF experience a substantial decrease in health-related quality of life compared to healthy subjects or affected by other diffused chronic diseases. Main body For both CVD and HF, prediction models have been developed, which utilize patient data, routine laboratory and further diagnostic tests. While some of these scores are currently used in clinical practice, there still is a need for innovative approaches to optimize CVD and HF prediction and to reduce the impact of these conditions on the global population. Epigenetic biomarkers, particularly DNA methylation (DNAm) changes, offer valuable insight for predicting risk, disease diagnosis and prognosis, and for monitoring treatment. The present work reviews current information relating DNAm, CVD and HF and discusses the use of DNAm in improving clinical risk prediction of CVD and HF as well as that of DNAm age as a proxy for cardiac aging. Conclusion DNAm biomarkers offer a valuable contribution to improving the accuracy of CV risk models. Many CpG sites have been adopted to develop specific prediction scores for CVD and HF with similar or enhanced performance on the top of existing risk measures. In the near future, integrating data from DNA methylome and other sources and advancements in new machine learning algorithms will help develop more precise and personalized risk prediction methods for CVD and HF.

Background: Cardiovascular diseases (CVD) account for approximately one-third of all deaths worldwide. The incidence of cardiovascular events such as myocardial infraction has been reported to be progressively increasing with age, especially with existing comorbidities such as hypertension, diabetes and obesity. Assessing arterial stiffness indices may serve as a screening tool in identification of population at risk of cardiovascular diseases and assist in implementation of preventive measures and early treatment in this population. Objectives: To measure and compare the arterial stiffness indices in healthy adults with diabetes, hypertension and obesity. Methods: A total of 184 adults in the age group of 30-50 years were included in the study who were divided into 4 groups: Group I (n = 64) (diabetic), group II (n = 40) (hypertensives), group III (n = 40) (obese) and group IV (n = 40) (control). The arterial stiffness indices were measured by using a certified oscillometric device in all the participants. Results: The arterial stiffness indices were assessed by using a certified oscillometric device in all the participants. The mean values of right baPWV and left baPWV are found to be significantly higher in hypertensive subjects compared with obese, diabetic and healthy controls. Conclusion: The pulse wave velocity, ASI and pulse pressure serve as independent predictors of cardiovascular mortality and outcomes in hypertension, diabetes and obesity as well as healthy individuals.

Abstract Cardiovascular disease (CVD) remains the predominant cause of mortality and disability worldwide. Against this backdrop, finding effective drugs for the pharmacological treatment of CVD has become one of the most urgent and challenging issues in medical research. Garlic (Allium sativum L.) is one of the oldest plants and is world-renowned for its dietary and medicinal values. Allicin (diallyl thiosulfinate) is one of the primary natural active ingredients in garlic, which has been proven to have powerful cardioprotective effects and mediate various pathological processes related to CVD, such as inflammatory factor secretion, myocardial cell apoptosis, oxidative stress, and more. Therefore, allicin holds a promising application prospect in the treatment of CVD. This review summarized the biological functions of allicin and its potential mechanisms in CVD, including antioxidation, anti-inflammation, and anti-apoptosis effects. Reckoning with these, we delved into recent studies on allicin’s cardioprotective effects concerning various CVDs, such as atherosclerosis, hypertension, myocardial infarction, arrhythmia, cardiac hypertrophy, heart failure, and cardiotoxicity. Further, considering the tremendous advancement in nanomedicine, nanotechnology-based drug delivery systems show promise in addressing limitations of allicin’s clinical applications, including improving its solubility, stability, and bioavailability. Through this review, we hope to provide a reference for further research on allicin in cardioprotection and drug development. Graphical Abstract

Heart disease represents the leading cause of death globally. Timely diagnosis and treatment can prevent cardiovascular issues. An Electrocardiograms (ECG) serves as a diagnostic tool for identifying heart difficulties. Cardiovascular Disease (CVD) often gets identified through ECGs. Deep learning (DL) garners attention in healthcare due to its potential in swiftly diagnosing ECG anomalies, crucial for patient monitoring. Conversely, automatic CVD detection from ECGs poses a challenging task, wherein rule-based diagnostic models usually achieve top-notch performance. These models encounter complications in supervision vast volumes of diverse data, demanding widespread analysis and medical capability to ensure precise CVD diagnosis. This study aims to enhance cardiovascular disease diagnosis by combining symptom-based detection and ECG analysis. To enhance these experiments, we built a novel automated prediction method based on a Feed Forward Neural Network (FFNN) model. The fundamental objective of our method is to develop the accuracy of ECG diagnosis. Our strategy employs chaos theory and destruction analysis to combine optimum deep learning features with a well-organized set of ECG properties. In addition, we use the constant-Q non-stationary Gabor transform (CQNGT) to convert one-dimensional ECG data into a two-dimensional picture. A pre-trained FFNN processes this image. To identify significant features from the FFNN output that correspond with the ECG data, we employ pairwise feature proximity. According to experimental findings, the suggested system, FFNN-CQNGT, surpasses other state-of-the-art systems in terms of precision of 94.89%, computational efficiency of 2.114 ms, accuracy of 95.55%, specificity of 93.77%, and sensitivity of 93.99% and MSE 40.32%. Contributing an automated ECG-based DL system based on FFNN-CQNGT for early-stage cardiovascular disease identification and classification holds great potential for both patient care and public health. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVD) affect over half a billion people worldwide and are the leading cause of global deaths. In particular, due to population aging and worldwide spreading of risk factors, the prevalence of heart failure (HF) is also increasing. HF accounts for approximately 36% of all CVD-related deaths and stands as the foremost cause of hospitalization. Patients affected by CVD or HF experience a substantial decrease in health-related quality of life compared to healthy subjects or affected by other diffused chronic diseases. Main body: For both CVD and HF, prediction models have been developed, which utilize patient data, routine laboratory and further diagnostic tests. While some of these scores are currently used in clinical practice, there still is a need for innovative approaches to optimize CVD and HF prediction and to reduce the impact of these conditions on the global population. Epigenetic biomarkers, particularly DNA methylation (DNAm) changes, offer valuable insight for predicting risk, disease diagnosis and prognosis, and for monitoring treatment. The present work reviews current information relating DNAm, CVD and HF and discusses the use of DNAm in improving clinical risk prediction of CVD and HF as well as that of DNAm age as a proxy for cardiac aging. Conclusion: DNAm biomarkers offer a valuable contribution to improving the accuracy of CV risk models. Many CpG sites have been adopted to develop specific prediction scores for CVD and HF with similar or enhanced performance on the top of existing risk measures. In the near future, integrating data from DNA methylome and other sources and advancements in new machine learning algorithms will help develop more precise and personalized risk prediction methods for CVD and HF. [ABSTRACT FROM AUTHOR]

Objective: Previous research has primarily focused on the incidence and mortality rates of Merkel cell carcinoma (MCC), neglecting the examination of cardiovascular mortality (CVM) risk among survivors, particularly older patients. This study aims to assess the risk of CVM in older individuals diagnosed with MCC. Methods: Data pertaining to older MCC patients were obtained from the Surveillance, Epidemiology, and End Results database (SEER). CVM risk was measured using standardized mortality ratio (SMR) and cumulative mortality. Multivariate Fine-Gray's competing risk model was utilized to evaluate the risk factors contributing to CVM. Results: Among the study population of 2,899 MCC patients, 465 (16.0%) experienced CVM during the follow-up period. With the prolongation of the follow-up duration, the cumulative mortality rate for CVM reached 27.36%, indicating that cardiovascular disease (CVD) became the second most common cause of death. MCC patients exhibited a higher CVM risk compared to the general population (SMR: 1.69; 95% CI: 1.54–1.86, p < 0.05). Notably, the SMR for other diseases of arteries, arterioles, and capillaries displayed the most significant elevation (SMR: 2.69; 95% CI: 1.16–5.29, p < 0.05). Furthermore, age at diagnosis and disease stage were identified as primary risk factors for CVM, whereas undergoing chemotherapy or radiation demonstrated a protective effect. Conclusion: This study emphasizes the significance of CVM as a competing cause of death in older individuals with MCC. MCC patients face a heightened risk of CVM compared to the general population. It is crucial to prioritize cardiovascular health starting from the time of diagnosis and implement personalized CVD monitoring and supportive interventions for MCC patients at high risk. These measures are essential for enhancing survival outcomes. [ABSTRACT FROM AUTHOR]

Background It is unknown whether growth differentiation factor 15 (GDF-15) is associated with chronic musculoskeletal pain (CMP) and whether or not its association with incident cardiovascular disease (CVD) changes according to CMP status. Methods In total, 1 957 randomly selected adults aged ≥65 years without prior CVD were followed up between 2015 and 2023. CMP was classified according to its intensity, frequency, and interference with daily activities. The association between GDF-15 levels and CMP was assessed using linear models with progressive inclusion of potential confounders, whereas the association between GDF-15 and CVD risk was evaluated with Cox proportional hazard models with similar adjustment and interaction terms between GDF-15 and CMP. The incremental predictive performance of GDF-15 over standard predictors was evaluated using discrimination and risk reclassification metrics. Results GDF-15 concentrations were 6.90% (95% confidence interval [CI]: 2.56; 11.25) higher in individuals with CMP, and up to 8.89% (4.07; 15.71) and 15.79% (8.43; 23.16) higher in those with ≥3 CMP locations and interfering pain. These increased levels were influenced by a higher prevalence of cardiometabolic risk factors, functional impairments, depressive symptoms, and greater levels of inflammation in individuals with CMP. In fully adjusted models, a twofold increase in GDF-15 was associated with a 1.49 increased risk (95% CI: 1.08; 2.05) of a CVD event in individuals with CMP, but not among those without CMP (1.02 [0.77; 1.35]); p- interaction 0.041. Adding GDF-15 to models including the Framingham Risk Score improved predictive performance among individuals with CMP. Conclusions We provide evidence that GDF-15 could serve as a biomarker to assess CMP, as well as to predict CVD incidence in individuals with CMP. [ABSTRACT FROM AUTHOR]

Arteriosclerosis (AS) presents a significant global health challenge, demanding innovative therapeutic strategies. This review explores the potential of nanoparticles (NPs) and mesenchymal stem cells (MSCs) as promising modalities for treating AS. NPs enable targeted drug delivery, while MSCs possess immunomodulatory and regenerative capabilities. We discuss recent advances in NP-based drug delivery systems tailored for AS treatment and highlight MSCs’ roles in modulating inflammation and promoting vascular repair. Additionally, we examine the synergistic effects of combining NPs and MSCs for enhanced therapeutic outcomes. Furthermore, this paper provides insights into targeting endothelial cells, T-cells, macrophages, lipid levels, and plaques in AS using MSCs. It also reviews various types of metal-based and non-metallic NPs utilized in AS therapy. This comprehensive overview underscores the potential synergies between MSCs and NPs in cardiovascular disease therapy, emphasizing the need for further research to fully realize their therapeutic implications. [ABSTRACT FROM AUTHOR]

Background: The importance of identifying mortality biomarkers in chronic kidney disease (CKD), and especially in patients treated with hemodialysis (HD), has become evident. In addition to being a marker of tubulointerstitial injury, plasma kidney injury molecule-1 (KIM-1) has been mentioned in regard to HD patients as a risk marker for cardiovascular (CV) mortality and coronary artery calcification. The aim of this study was to assess the level of plasma KIM-1 as a marker of cardiovascular disease (CVD) and mortality in CKD5-HD patients (patients with CKD stage G5D treated with hemodialysis). Methods: We conducted a prospective case–control study that included 63 CKD5-HD patients (HD for 1–5 years) followed up for 48 months and a control group consisting of 52 non-dialysis patients diagnosed with CKD stages G1-G5 (ND-CKD). All patients had a CVD baseline assessment including medical history, echocardiography, and electrocardiography (ECG). Circulating plasma KIM-1 levels were determined with single-molecule counting immunoassay technology using an enzyme-linked immunosorbent assay. We obtained the following parameters: serum creatinine and urea; the inflammation markers CRP (C-reactive protein) and IL-6 (interleukin-6); and the anemia markers complete blood count, serum ferritin, and transferrin saturation (TSAT). Results: The mean plasma KIM-1 level was 403.8 ± 546.8 pg/mL, showing a statistically significant correlation with inflammation (CRP, R = 0.28, p = 0.02; IL-6, R = 0.36, p = 0.005) and with anemia (hematocrit, R = −0.5, p = −0.0316; hemoglobin (Hb), R = −0.5, p = 0.02). We found that patients with left ventricular hypertrophy (LVH) on echocardiography (59.7%) had significantly lower mean levels of plasma KIM-1 than patients from the control group (155.51 vs. 432.12 pg/mL; p = 0.026). Regarding the patients' follow-up, we assessed all-cause mortality as an endpoint. After 24 months of follow-up, we found a mortality rate of 22.23%, while after 48 months, the mortality rate was 50.73%. A plasma KIM-1 level < 82.98 pg/mL was significantly associated with decreased survival in hemodialysis patients (p < 0.001). Conclusions: In patients treated with hemodialysis, low levels of plasma KIM-1 were associated with cardiovascular changes and an increased risk of mortality. Plasma KIM-1 levels were significantly higher in HD patients compared to ND-CKD patients. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) remains the predominant cause of mortality and disability worldwide. Against this backdrop, finding effective drugs for the pharmacological treatment of CVD has become one of the most urgent and challenging issues in medical research. Garlic (Allium sativum L.) is one of the oldest plants and is world-renowned for its dietary and medicinal values. Allicin (diallyl thiosulfinate) is one of the primary natural active ingredients in garlic, which has been proven to have powerful cardioprotective effects and mediate various pathological processes related to CVD, such as inflammatory factor secretion, myocardial cell apoptosis, oxidative stress, and more. Therefore, allicin holds a promising application prospect in the treatment of CVD. This review summarized the biological functions of allicin and its potential mechanisms in CVD, including antioxidation, anti-inflammation, and anti-apoptosis effects. Reckoning with these, we delved into recent studies on allicin's cardioprotective effects concerning various CVDs, such as atherosclerosis, hypertension, myocardial infarction, arrhythmia, cardiac hypertrophy, heart failure, and cardiotoxicity. Further, considering the tremendous advancement in nanomedicine, nanotechnology-based drug delivery systems show promise in addressing limitations of allicin's clinical applications, including improving its solubility, stability, and bioavailability. Through this review, we hope to provide a reference for further research on allicin in cardioprotection and drug development. [ABSTRACT FROM AUTHOR]

Mortality from cardiovascular disease (CVD) accounts for over 30% of all deaths globally, necessitating reliable diagnostic tools. Prompt identification and precise diagnosis are critical for effective personalized treatment. Nanotechnology offers promising applications in diagnostics, biosensing and drug delivery for prevalent cardiovascular diseases. Its integration into cardiovascular care enhances diagnostic accuracy, enabling early intervention and tailored treatment plans. By leveraging nanoscale innovations, healthcare professionals can address the complexities of CVD progression and customize interventions based on individual patient needs. Ongoing advancements in nanotechnology continue to shape the landscape of cardiovascular medicine, offering potential for improved patient outcomes and reduced mortality rates from these pervasive diseases. Article highlights Nanotechnology in early cardiac marker detection Nanoparticles possess a wide range of capabilities for diagnostic purposes, namely in the realm of early identification of atherosclerosis by the quantification of inflammatory markers. Precision and effectiveness are essential for the detection of heart-type fatty acid-binding protein (H-FABP) as an early biomarker for cardiac events. Several techniques, such as chromatography (HPLC, GC-MS) and immunoassays (ELISA, LFIA), can be used with distinct advantages in terms of sensitivity, specificity and turnaround time. Challenges with immunoassays include the occurrence of cross-reactivity and interference, while chromatographic procedures require specialized equipment and skilled personnel. MicroRNAs (miRNAs) control gene expression and exhibit stability in human fluids, rendering them valuable as biomarkers. miRNA-21 is a biomarker that is specifically intriguing for heart failure due to its involvement in both the etiology and diagnostics of the condition. Therapeutic approaches aimed at miRNA-21 entail the use of antagomiRs and miRNA mimics, which present opportunities for precision medicine. miRNA-21 is involved in heart hypertrophy, fibrosis and remodeling, and its abnormal regulation offers diagnostic and prognostic information. Current challenges & limitations in early detection Early diagnosis of heart issues is essential for effective treatment and better outcomes. Advanced cardiac implantable electronic devices (CIEDs) are increasingly employed for congestive heart failure, ventricular tachyarrhythmia and bradyarrhythmia. Regular battery changes remain necessary, despite breakthroughs in battery design and CIED programming, resulting in cost, risk and inconvenience. Transvenous lead extraction for damaged leads is potentially fatal. Spin-echo (SE) sequences, enhanced by ECG-gating, improve myocardial-blood contrast but have limited temporal resolution and motion-related artefacts. Ejection fraction (EF), a typical systolic function measure, is susceptible to inaccuracies due to subjective endocardial boundary tracing. Emerging biochemical diagnostics for heart disease encounter hurdles in standardization, preanalytical variability and imprecision. Reliable economic evaluations of test costs and benefits are lacking. Immunoassays for novel cardiac proteins use antibodies targeting various epitopes, resulting in varying results and interpretation challenges. "Sandwich" immunoassays may produce false positives due to disturbances in antigen-antibody reactions and interference by factors like rheumatoid factor or human antimouse antibodies. The presence of endogenous substances like hemoglobin and bilirubin can lower the sensitivity and specificity of troponin assays. POC devices for cardiac troponins and BNP detection are sensitive yet expensive and time-consuming. Recent advances & innovations in early detection Patenting theranostic nanoparticles, developing a UV-cross-linkable cardiac patch with gold nano-rods and creating nanoparticle-based stem cell conjugates for post-infarction treatment are significant advances in spatially designed nanoparticle trials in CVDs, neurological disorders and cancer therapies. AuNPs and iron oxide nanoparticles improve imaging of atherosclerotic plaques and CVDs, with CNA35-AuNPs found to improve contrast and detection in CT images. MRI, utilizing T2 and T1 mapping, 4D flow imaging and nanoplatforms, enhances imaging accuracy and precision, replacing biopsies for heart structure, function and tissue characteristics. PET imaging in CVDs uses radioactive tracers for 3D imaging of biological processes, such as myocardial perfusion using 13N-ammonia, enhanced by nanoplatforms and targeting ligands improving specificity and effectiveness. Enhanced ultrasound imaging with nanoparticles targeting vascular markers enhances echogenicity and contrast-to-noise ratio, resulting in safe and effective real-time imaging. MSOT and PAI use photoacoustic imaging for high-resolution carotid artery and atherosclerosis detection, with nanoparticles improving sensitivity, contrast and specificity. MPI, a real-time, high-resolution imaging method, enhances signal strength and accuracy with optimized nanoparticles for tracer detection, multiplexed imaging and sensitivity. [ABSTRACT FROM AUTHOR]

To investigate the changes in the intestinal flora in the Chinese elderly with cardiovascular disease (CVD) and its correlation with the metabolism of trimethylamine (TMA), the intestinal flora composition of elderly individuals with CVD and healthy elderly individuals was analyzed using 16S rRNA sequencing, the TMA levels in the feces of elderly were detected using headspace–gas chromatography (HS-GC), and four kinds of characterized TMA-producing intestinal bacteria in the elderly were quantified using real-time fluorescence quantitative polymerase chain reaction (qPCR). The results showed that Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes, and Verrucomicrobia are the dominant microorganisms of the intestinal flora in the Chinese elderly. And there were significant differences in the intestinal bacteria composition between healthy elderly individuals and those with CVD, accompanied by a notable difference in the TMA content. The richness and diversity of the intestinal flora in the elderly with CVD were higher than those in the healthy elderly. Correlation analysis indicated that certain significantly different intestinal flora were associated with the TMA levels. Our findings showed a significant difference in TMA-producing intestinal flora between healthy elderly individuals and those with CVD. The TMA levels were found to be positively and significantly correlated with Klebsiella pneumoniae, suggesting that this bacterium is closely linked to the production of TMA in the elderly gut. This may have implications for the development and progression of CVD in the elderly population. [ABSTRACT FROM AUTHOR]

At present, there are few studies on the relationship between lipid accumulation product (LAP) and mortality. This study aims to explore the relationship between adult LAP and all-cause and cardiovascular disease (CVD) mortality. The study people from the National Health and Nutrition Examination Survey (NHANES). Results of the mortality study were based on death data up to December 31, 2019. Cox proportional risk model was used to estimate the risk ratio (HR) and 95 % CI of all-cause and CVD mortality. A total of 50162 people were included in the study (the weighted average age and male proportion were 48.14 years and 48.64 % respectively). During the follow-up of 203460871 person-years, 6850 deaths were recorded, including 1757 CVD deaths. After multivariable adjustment, the increase of LAP was significantly correlated with all-cause and CVD mortality. Compared with the participants of Quartile 1 of LAP, the multivariable adjusted HRs and 95 % CI of the participants of Quartile 4 of LAP were 1.54 (1.32, 1.80) all-cause mortality (P for trend<0.001), and 1.55 (1.16, 2.09) CVD mortality (P for trend = 0.04). For every increase of natural log-transformed LAP, the all-cause mortality increased by 22 %, and the CVD mortality increased by 14 % (both P < 0.05). Our cohort study based on NHANES showed that higher LAP was significantly associated with higher all-cause and CVD mortality. Maintaining a low LAP status may reduce the risk of death. • At present, there are few studies on the relationship between lipid accumulation product and mortality. • We study aims to study the relationship between adult LAP and all-cause and cardiovascular disease mortality. A total of 50162 people were included in the study. During the follow-up of 203460871 person-years, 6850 deaths were recorded, including 1757 cardiovascular disease deaths. • The increase of LAP was significantly correlated with all-cause and cardiovascular disease mortality. For every increase of natural log-transformed lipid accumulation product the all-cause mortality increased by 22 %, and the cardiovascular disease mortality increased by 14 %. • Our cohort study based on NHANES showed that higher LAP was significantly associated with higher all-cause and cardiovascular disease mortality. Maintaining a low LAP status may reduce the risk of death. [ABSTRACT FROM AUTHOR]

Previous research has suggested a potential link between vitamin D (VD) deficiency and adverse cardiovascular health outcomes, although the findings have been inconsistent. This study investigates the association between VD deficiency and cardiovascular disease (CVD) within the context of established CVD risk factors. We utilized a Random Forest model to predict both CVD and VD deficiency risks, using a dataset of 1,078 observations from a rural Chinese population. Feature importance was evaluated using SHapley Additive exPlanations (SHAP) to discern the impact of various risk factors on the model’s output. The results showed that the model for CVD prediction achieved a high accuracy of 87%, demonstrating robust performance across precision, recall, and F1 score metrics. Conversely, the VD deficiency prediction model exhibited suboptimal performance, with an accuracy of 52% and lower precision, recall, and F1 scores. Feature importance analysis indicated that traditional risk factors such as systolic blood pressure, diastolic blood pressure, age, body mass index, and waist-to-hip ratio significantly influenced CVD risk, collectively contributing to 70% of the model’s predictive power. Although VD deficiency was associated with an increased risk of CVD, its importance in predicting CVD risk was notably low. Similarly, for VD deficiency prediction, CVD risk factors such as systolic blood pressure, glucose levels, diastolic blood pressure, and body mass index emerged as influential features. However, the overall predictive performance of the VD deficiency prediction model was weak (52%), indicating the absence of VD deficiency-related risk factors. Ablation experiments confirmed the relatively lower importance of VD deficiency in predicting CVD risk. Furthermore, the SHAP partial dependence plot revealed a nonlinear relationship between VD levels and CVD risk. In conclusion, while VD deficiency appears directly or indirectly associated with increased CVD risk, its relative importance within predictive models is considerably lower when compared to other risk factors. These findings suggest that VD deficiency may not warrant primary focus in CVD risk assessment and prevention strategies, however, further research is needed to explore the causal relationship between VD deficiency and CVD risk.

Abstract Background Ambient ultraviolet radiation (UVR) has been found to have a greater cardioprotective effect than previously believed. This study aimed to quantitatively measure the role of UVR in protecting against the progression of cardiovascular disease (CVD) in general on a global and regional scale. Methods Population‐level data on UVR, CVD incidence, aging, economic affluence, CVD genetic background (indexed with the Biological State Index, Ibs), obesity prevalence, and urbanization were collected and analysed. The correlation between UVR and CVD was examined using bivariate correlations, partial correlation, and stepwise multiple linear regression. Countries were grouped to investigate regional correlations between UVR and CVD, and Fisher's r‐to‐z transformation was used to compare correlation coefficients. Results UVR showed a significant inverse correlation with CVD incidence rates in bivariate correlation analyses globally (r = − 0.775 and r = − 0.760, p

Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.36% of global deaths. The burden of hypertension in sub-Saharan Africa is significant, with an estimated 10–20 million people currently affected. Systemic barriers, such as fragmented health services and socioeconomic inequalities, coupled with shifts in greater salt-intake, ultra-processed foods, more sedentary lifestyles, and overburdened healthcare services, have exacerbated elevated blood pressure and poorer management of people living with hypertension in sub-Saharan Africa. Most public health strategies focus on detecting, treating, and controlling hypertension through lifestyle modifications and medication. However, evidence suggests only 10% of population hypertension is well managed. This indicates a growing need to shift towards preventative efforts. Precision prevention, a tailored health intervention approach utilising individual and population-specific factors – genetic, environmental, and social determinants – offers a potential alternative. Precision prevention aims to deliver the right preventative measures to the right population at the right time, promising to enhance intervention efficiency and health outcomes. This paper highlights various intervention levers, including environmental, biological, and behavioural modifications, examines case studies from high-income countries, and discusses the potential for implementing precision prevention in South Africa. While precision prevention shows promise, we also discuss the significant barriers to its implementation in LMICs such as those within sub-Saharan Africa.

Cancer and cardiovascular disease (CVD) are major causes of morbidity and mortality in the United States (US). Cancer survivors have increased risks for CVD and CVD-related mortality due to multiple factors including cancer treatment-related cardiotoxicity. Disparities are rooted in differential exposure to risk factors and social determinants of health (SDOH), including systemic racism. This review aimed to assess SDOH's role in disparities, document CVD-related disparities among US cancer survivors, and identify literature gaps for future research. Following the Peer Review of Electronic Search Strategies (PRESS) guidelines, MEDLINE, PsycINFO, and Scopus were searched on March 15, 2021, with an update conducted on September 26, 2023. Articles screening was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, a pre-defined Population , Exposure, Comparison, Outcomes, and Settings (PECOS) framework, and the Rayyan platform. A modified version of the Newcastle-Ottawa Scale was used to assess the risk of bias, and RAW Graphs for alluvial charts. This review is registered with PROSPERO under ID #CRD42021236460. Out of 7,719 retrieved articles, 24 were included, and discussed diverse SDOH that contribute to CVD-related disparities among cancer survivors. The 24 included studies had a large combined total sample size (n=7,704,645; median=19,707). While various disparities have been investigated, including rural–urban, sex, socioeconomic status, and age, a notable observation is that non-Hispanic Black cancer survivors experience disproportionately adverse CVD outcomes when compared to non-Hispanic White survivors. This underscores historical racism and discrimination against non-Hispanic Black individuals as fundamental drivers of CVD-related disparities. Stakeholders should work to eliminate the root causes of disparities. Clinicians should increase screening for risk factors that exacerbate CVD-related disparities among cancer survivors. Researchers should prioritise the investigation of systemic factors driving disparities in cancer and CVD and develop innovative interventions to mitigate risk in cancer survivors. [ABSTRACT FROM AUTHOR]

AbstractThe human gut microbiome has emerged as a key influencer of human health and disease, particularly through interactions with dietary fiber. However, national dietary guidelines worldwide are only beginning to capitalize on the potential of microbiome research, which has established the vital role of host-microbe interactions in mediating the physiological effects of diet on overall health and disease. β-glucans have been demonstrated to modulate the composition of the gut microbiota, leading to improved outcomes in cardiovascular disease (CVD). Raised serum cholesterol and blood pressure are important modifiable risk factors in the development of CVD and emerging evidence highlights the role of the gut microbiota in ameliorating such biomarkers and clinical characteristics of the disease. The proposed mechanism of action of β-glucans on the pathophysiological mechanisms of disease have yet to be elucidated. Validating gaps in the literature may substantiate β-glucans as a potential novel dietary therapy against modifiable risk factors for CVD and would further support the public health significance of including a habitual fiber-rich diet. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate whether physical activity and the level of body fat are factors reducing the level of pro‐inflammatory cytokines in people with T1DM. Twenty‐five men (27.8 ± 9.4 years old; 178.9 ± 6.9 cm; 80.6 ± 12 kg) and 18 women (28.1 ± 12.5 years old; 162.4 ± 5.5; 63.1 ± 9.9 kg) were divided into four groups based on body fat percentage and level of physical activity (AN—active people with normal body fat; IAN—inactive people with normal body fat; AO—active people with excessive body fat, IAO—inactive people with excessive body fat). The level of cytokines in the blood serum was assessed. The level of IL‐8 was higher (measurable) in inactive men, regardless of adiposity degree and in women, only in the inactive group with normal body fat. IL‐6 was found only in active men with excessive adiposity. In conclusion, the findings from this study allow to indicate that moderate level of physical activity may contribute to a reduction in the development of systemic low‐grade inflammation in patients with T1DM, and thus, may reduce the risk of CVD. [ABSTRACT FROM AUTHOR]

Atherosclerosis, a complex metabolic-immune disease characterized by chronic inflammation driven by the buildup of lipid-rich plaques within arterial walls, has emerged as a pivotal factor in the intricate interplay between cancer and cardiovascular disease. This bidirectional relationship, marked by shared risk factors and pathophysiological mechanisms, underscores the need for a comprehensive understanding of how these two formidable health challenges intersect and influence each other. Cancer and its treatments can contribute to the progression of atherosclerosis, while atherosclerosis, with its inflammatory microenvironment, can exert profound effects on cancer development and outcomes. Both cancer and cardiovascular disease involve intricate interactions between general and personal exposomes. In this review, we aim to summarize the state of the art of translational data and try to show how oncologic studies on cardiotoxicity can broaden our knowledge of crucial pathways in cardiovascular biology and exert a positive impact on precision cardiology and cardio-oncology. [ABSTRACT FROM AUTHOR]

Nowadays, automated analysis of the electrocardiogram (ECG) signal is a popular choice to facilitates easy and expert-independent detection of lethal cardiovascular diseases (CVDs). Although, a majority of the state-of-the-art algorithms are found to be lagging due to the use of complicated methodologies, limited dataset, high feature dimension, feature selection or intense classification techniques. In this research an original, easy-to-use ECG based methodology is proposed for completely automated identification of multiple types of critical CVDs. Primarily, after preprocessing the algorithm uses a simplified technique for exact detection of ECG fiducial points. Then, based on detected fiducial points, some well interpretable and prominent ECG time domain features are efficiently extracted and a binary feature matrix has been derived using those features from different leads. Finally, a distinctive score is evaluated from the binary feature matrix calculating the sum of weighted feature value and only by utilizing the score,discrimination between the various types of CVDs is highly detectable. Proficiency of the algorithm is widely evaluated on the 12-lead ECG signal data collected from Physikalisch-Technische-Bundesanstalt (PTB) and PTB-XL database. The algorithm presents promising outcome with average accuracy, sensitivity and specificity of 99.43%, 98.27% and 99.59%, respectively. Evidently, the algorithm is capable enough and efficient as well in comparison with other reported techniques till date. Moreover, the use of a unique score derived from the binary matrix ascertains the exact detection of multiple cardiac abnormalities and the superior classification accuracy makes the algorithm promising for personal computerized health monitoring applications. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs), including Myocardial infarction (MI), Stroke, and heart failure (HF), remain major global health challenges. Lifestyle factors such as poor diet, sedentary behavior, and stress contribute to the development and progression of CVD. Many nutraceuticals are rich in antioxidants, which combat oxidative stress and inflammation implicated in cardiovascular diseases. Polyphenols, found in fruits, vegetables, tea, and red wine, have demonstrated anti-inflammatory and vasodilatory effects. Omega-3 fatty acids, which are abundant in fatty fish, flaxseeds, and walnuts, are recognized for their positive effects on heart health. They can reduce triglyceride levels, and lower blood pressure, in addition to their anti-inflammatory effects. These naturally-derived compounds, found in certain nuts, seeds, and vegetable oils, have been shown to lower LDL cholesterol levels, reducing the risk of atherosclerosis. Garlic contains allicin, known for its potential to lower cholesterol and blood pressure. Turmeric's active compound, curcumin, has anti-inflammatory and antioxidant properties that may benefitcardiovascular health. CoQ10 is an antioxidant naturally present in the body, and it plays a crucial role in energy production in cells. Dietary fiber, found in fruits, vegetables, and whole grains, can help regulate cholesterol levels, blood pressure, and body weight, contributing to overall cardiovascular health. Vitamin K2, found in fermented foods and certain animal products, may play a role in preventing arterial calcification and promoting heart health. Research in this field is ongoing, and while promising, it is essential to consider nutraceuticals as part of a holistic approach to cardiovascular health. As the understanding of nutraceuticals and their impact on cardiovascular health continues to evolve, further clinical trials and long-term studies will provide more insights, helping to establish their role in the prevention and management of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: Serum albumin levels and cancer mortality are closely related, yet large-sample studies encompassing a broad spectrum of cancer types are lacking. Methods: This study encompassed patients diagnosed with cancer across the continuous 10 cycles of NHANES surveys from 1999 to 2018. The study population was stratified into two groups based on median albumin levels (≤ 4.2g/dL and > 4.2 g/dL) or cancer aggressiveness (well-survived cancers and poorly-survived cancers). Survival rates were estimated using the Kaplan-Meier method. The Cox proportional hazards model was employed to evaluate the association between serum albumin levels and cancer mortality. Restricted cubic spline (RCS) analysis was conducted to assess the nonlinear relationship between serum albumin levels and the risk of cancer mortality. Results: Kaplan-Meier curves demonstrated that patients with albumin levels ≤ 4.2 g/dL exhibited lower survival rates compared to those with levels > 4.2 g/dL, irrespective of cancer aggressiveness. Following adjustment for confounders, decreased albumin levels were associated with an elevated risk of cancer mortality across all groups [all cancers, HR (95%CI) = 2.03(1.73, 2.37); well survived cancers, HR (95%CI) = 1.78(1.38, 2.32); and poorly survived cancers, HR (95%CI) = 1.99(1.64, 2.42)]. RCS analyses revealed a stable nonlinear negative association between albumin levels and cancer mortality in all groups, regardless of confounder adjustment. Conclusion: Low serum albumin levels predict higher cancer mortality. Furthermore, a nonlinear negative association was observed between serum albumin levels and the risk of cancer mortality. [ABSTRACT FROM AUTHOR]

Introduction: Trinidad & Tobago has the highest prevalence of cardiovascular disease (CVD) in the Caribbean and clopidogrel is a ubiquitously used treatment. Yet, the extent of genetically mediated clopidogrel resistance is unknown. To determine this, we investigated whether the association between CYP2C19*2 and CYP2C19*3 genetic variants and clopidogrel resistance holds, and calculated the frequencies of these in the Trinidadian CVD population. Methods: Demographic data, clinical data, and a saliva sample were collected under informed consent from 22 patients with CVD on dual anti-platelet therapy whose biochemical resistance to clopidogrel is known, and a further 162 patients accessing the main public CVD clinic in Trinidad and who are either currently being treated or are likely to be treated with clopidogrel. A polymerase chain reaction (PCR) and restriction enzyme digestion procedure was used to genotype each patient for the CYP2C19*2 and CYP2C19*3 allelic variants. Genotype was compared to known clopidogrel resistance in the 22 patients, and to disease status and clopidogrel usage in the larger cohort. Results: CYP2C19*2 genotype was concordant with clopidogrel resistance. CYP2C19*2 was detected in 61.1% (99/162) of patients and CYP2C19*3 was undetected. Clopidogrel was the most prescribed antiplatelet therapy (42%). A total of 120 people presented with coronary artery disease (CAD) and 52.5% of these (n = 63/120) are currently prescribed clopidogrel. 63.5% (40/63) of patients with CAD who are prescribed clopidogrel carry the CYP2C19*2 allele; ten homozygous and 30 heterozygous. Indian patients comprised 65% of the cohort and were four times more likely to carry the CYP2C19*2 allele than African patients. Conclusions: A large proportion of Trinidadian patients with CVD who are prescribed or may be prescribed clopidogrel carry genetic variants associated with clopidogrel resistance. These results emphasize the clinical need for further investigation into whether CYP2C19*2 genotype should guide clopidogrel use for the cardiovascular disease population in Trinidad & Tobago. A slide deck is available for this article. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a global health issue with a rising prevalence, affecting 697.5 million people worldwide. It imposes a substantial burden, contributing to 35.8 million disability-adjusted life years (DALYs) and 1.2 million deaths in 2017. The mortality rate for CKD has increased by 41.5% between 1990 and 2017, positioning it as a significant cause of global mortality. CKD is associated with diverse health complications, impacting cardiovascular, neurological, nutritional, and endocrine aspects. One prominent complication is CKD–mineral and bone disorder (MBD), a complex condition involving dysregulation of bone turnover, mineralization, and strength, accompanied by soft tissue and vascular calcification. Alterations in mineral metabolism, including calcium, phosphate, parathyroid hormone (PTH), vitamin D, fibroblast growth factor-23 (FGF-23), and Klotho, play pivotal roles in CKD-MBD. These disturbances, observed early in CKD, contribute to the progression of bone disorders and renal osteodystrophy (ROD). Vascular calcification (VC) is a key component of CKD-MBD, accelerated by CKD. The pathophysiology involves complex processes in vascular smooth muscle cells and the formation of calciprotein particles (CPP). VC is closely linked to cardiovascular events and mortality, emphasizing its prognostic significance. Various serum markers and imaging techniques, including lateral plain X-ray, Kauppila Score, Adragao Score, and pulse wave velocity, aid in VC detection. Additionally, pQCT provides valuable information on arterial calcifications, offering an advantage over traditional scoring systems. CKD poses a substantial global health burden, and its complications, including CKD-MBD and VC, significantly contribute to morbidity and mortality. Understanding the intricate relationships between mineral metabolism, bone disorders, and vascular calcification is crucial for effective diagnosis and therapeutic interventions. [ABSTRACT FROM AUTHOR]