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Physical Activity for the Prevention of Cardiovascular Diseases

ABBREVIATIONS ACSM - American College of Sports Medicine AHA - American Heart Association BP - blood pressure CRP - C-reactive protein CVD - cardiovascular diseases CHD - coronary heart disease eNOS - endothelial nitric oxide synthase ET-1 - endothelin-1 HbA1c - glycated haemoglobin HDL-C - high-density lipoprotein cholesterol IL-6 - interleukin-6 LDL-C - low-density lipoprotein cholesterol NO - nitric oxide PA - physical activity PF - physical fitness ROS - reactive oxygen species TNF - tumour necrosis factor T2D - type 2

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The Role of HMG COA Reductase Inhibitors on the Progression of Coronary Artery Disease: Focus on Prediction Model

Abstract

Currently, an integrated site-specific and patient-specific comprehensive predictive model of plaque progression in various CVD is not available. In this study, we considered medical records of 256 patients obtained within the EU H2020 SMARTool project which is carefully designed to collect the features from various domains relevant for disease which are used in everyday clinical practice. The database contains detailed information of patients with suspected CAD disease regarding the clinical status, risk factors, routine blood analyses, CAD morphology and progression and current therapy. Results showed that there was statistically significant difference of values of this parameter for the SMARTool patients with and without disease progression, measured at the follow-up, F(1,250)=33.39, p < 0.001, while the CAD Score in the follow-up is significantly different from the score measured at the initial time point, F(1,254)=76.244, p < 0.001. The significant interaction of statins is achieved with aspirin F(1,252)= 3.921, p=0.049, while interactions with other medicaments are insignificant for CAD Score. The results showed that there was no significant interaction of statins and dyslipidemia, F(1,251)=0.877, p = 0.350. Also, there was no significant interaction of statins and hypertension, F(1,245)=0.283, p=0.596. The CAD score in the baseline was significantly different among patients who were further prescribed with therapy than those who were not, and this trend remained unchanged after a given time period, i.e. those patients who were at risk had progression in addition to statins, but the combination of statins and aspirin was shown as effective in decreasing the CAD Score. The Random Forest classifier applied on 24 selected features is the most reliable among all tested ML algorithms for the prediction of CAD progress.

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The metabolic syndrome in Bulgaria

mortality in Bulgaria. A compromising championship. Sofia: University Press “St. Kliment Ochridski”; 1995:224-6. 9. Health in Bulgaria: Report produced by the Health Information Unit of the WHO Regional Office for Europe in collaboration with the Ministry of Health and with the support of the European Commission and that of the Ministry of health of Finland. E73818, 2001. 10. Merjanov C. Bulgaria - a world leader in CVD mortality. A compromising championship. Sofia: University Press “St. Kliment Ochridski”; 1995:224-6. 11

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Health behavior and health-related quality of life in patients with a high risk of cardiovascular disease

improved ( 10 ). High-risk patients for cardiovascular disease (CVD) typically have risk factors, which include so called “risk diseases”, such as arterial hypertension and hyperlipidaemia, in combination with a poor lifestyle. Medical intervention is directed toward the treatment of risk diseases and the improvement of lifestyle. HRQoL in patients with isolated risk diseases, such as obesity, also profit from interventions directed toward the improvement of lifestyle ( 11 ). Even arterial hypertension, a silent disease, showed an influence on the quality of life in

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Glycemic index and glycemic load in preventive cardiology – the state of knowledge, selected controversies

Abstract

The current epidemiological situation in Poland is characterized by prevalence of cardiovascular diseases (CVD) as the main cause of mortality. In the paper the current state of knowledge on the importance of glycemic index (GI) and glycemic load (GL) in CVD prevention is presented, taking into consideration the latest recommendations on CVD prevention. In a nutrition strategy based on consumption of low GI/GL foods, the target of the intervention is the profile of dietary carbohydrates which is treated as a modulator of glycemic response. In the light of the current state of research, there is no reason to treat GI/GL values as markers of pro-health qualities of the dietary plan recommended in CVD prevention to individuals with normal glucose homeostasis. However, the preventive potential of diets characterized by low GI/GL deserves a more extensive application in patients with glucose homeostasis disturbances, including those with prediabetes and insulin resistance syndrome. Taking into account the relations between abnormal carbohydrate metabolism and a risk of developing diabetes, followed by CVD, the benefits of low-glycemic diets in individuals with impaired glucose homeostasis can indirectly result in lowering the risk of CVD. It is reasonable to conduct further clinical studies on the relevance of low GI/GL diets in preventive cardiology.

Open access
Lipophilic chemical exposure as a cause of cardiovascular disease

Abstract

Environmental chemical exposure has been linked to numerous diseases in humans. These diseases include cancers; neurological and neurodegenerative diseases; metabolic disorders including type 2 diabetes, metabolic syndrome and obesity; reproductive and developmental disorders; and endocrine disorders. Many studies have associated the link between exposures to environmental chemicals and cardiovascular disease (CVD). These chemicals include persistent organic pollutants (POPs); the plastic exudates bisphenol A and phthalates; low molecular weight hydrocarbons (LMWHCs); and poly nuclear aromatic hydrocarbons (PAHs). Here it is reported that though the chemicals reported on differ widely in chemical properties and known points of attack in humans, a common link exists between them. All are lipophilic species that are found in serum. Environmentally induced CVD is related to total lipophilic chemical load in the blood. Lipophiles serve to promote the absorption of otherwise not absorbed toxic hydrophilic species that promote CVD.

Open access
Community Noise Exposure and its Effect on Blood Pressure and Renal Function in Patients with Hypertension and Cardiovascular Disease

Abstract

Background: Road traffic noise (RTN) is a risk factor for cardiovascular disease (CVD) and hypertension; however, few studies have looked into its association with blood pressure (BP) and renal function in patients with prior CVD.

Aim: This study aimed to explore the effect of residential RTN exposure on BP and renal function in patients with CVD from Plovdiv Province.

Materials and methods: We included 217 patients with ischemic heart disease and/or hypertension from three tertiary hospitals in the city of Plovdiv (March – May 2016). Patients’ medical history, medical documentation, and medication regimen were reviewed, and blood pressure and anthropometric measurements were taken. Blood samples were analyzed for creatinine, total cholesterol, and blood glucose. Participants also filled a questionnaire. Glomerular filtration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. All participants were asked about their annoyance by different noise sources at home, and those living in the city of Plovdiv (n = 132) were assigned noise map Lden and Lnight exposure. The effects of noise exposure on systolic blood pressure (SBP), diastolic blood pressure (DBP), and estimated glomerular filtration rate (eGFR) were explored using mixed linear models.

Results: Traffic noise annoyance was associated with higher SBP in the total sample. The other noise indicators were associated with non-significant elevation in SBP and reduction in eGFR. The effect of Lden was more pronounced in patients with prior ischemic heart disease/stroke, diabetes, obesity, not taking Ca-channel blockers, and using solid fuel/gas at home. Lnight had stronger effect among those not taking statins, sleeping in a bedroom with noisy façade, having a living room with quiet façade, and spending more time at home. The increase in Lden was associated with a significant decrease in eGFR among men, patients with ischemic heart disease/stroke, and those exposed to lower air pollution. Regarding Lnight, there was significant effect modification by gender, diabetes, obesity, and time spent at home. In some subgroups, the effect of RTN was statistically significant.

Conclusions: Given that generic risk factors for poor progression of cardiovascular diseases cannot be controlled sufficiently at individual level, environmental interventions to reduce residential noise exposure might result in some improvement in the management of blood pressure and kidney function in patients with CVD.

Open access
Ubiquinone Plasma Levels are Correlated with Brain Natriuretic Peptide Plasma Levels in Patients with Chronic Heart Failure: The Potential of Coenzyme Q10 Combined Therapy

Abstract

Despite the association of a worse HF-related clinical status with lower CoQ10 levels, the prognostic use of CoQ10 is controversial. The aim of this study is to optimize pharmacotherapy for patients with ischaemic CHF, based on the clinical and functional parameters of the heart and brain natriuretic peptide (BNP) plasma levels, which are correlated with the CoQ10 plasma levels, and to assess patient prognosis after receiving CoQ10 therapy. This prospective clinical study included 75 patients aged 56 to 63 years old with coronary heart disease (CHD) classified as class I–III according to the NYHA classification. After assessment of the clinical-instrumental characteristics of the CVD course (complaints, medical history, physical examination, a 6-minute walk test, echocardiography, and test for reactive hyperaemia), we determined the BNP level and CoQ10 plasma levels. At the same time, we assessed the efficacy of CoQ10 treatment (at a dose of 60 mg/per day) and tolerability in CVD-combined therapy during a follow-up of 12 weeks. CoQ10 supplementation in HF patients induced improvements in their functional cardiac parameters, such as the ejection fraction. Our results suggest that supplemental CoQ10 may be a useful option for effective management of heart failure and warrant future adequately powered randomized controlled trials of CoQ10 supplementation in patients with HF.

Open access
Comorbidities of COPD in Bulgarian Patients – Prevalence and Association with Severity and Inflammation

Abstract

Background:wis a disease with constantly rising economic and social burden; it is associated with multiple comorbidities which contribute to the disease severity.

Aim: To investigate the prevalence of co-morbidities in COPD patients and their association with the disease severity and CRP levels.

Patients and methods: We conducted a retrospective study among 338 COPD patients (mean age 65.2±7.6 years) with assessment of comorbidities, spirometry measurements and serum levels of CRP. In 183 patients we found metabolic syndrome (MS) according to IDF criteria.

Results: We found prevalence of cardiovascular diseases (CVD) of 73.5% (hyper-tension 70.4%, CHF 47.4%, ishemic heart disease 37.5%, and cardiac arrhythmias 12.6%), with higher prevalence in patients with more severe disease. We found prevalence of type 2 diabetes of 21.1%, and 12.4% prevalence of bronchiectasis. In a subpopulation of the patients we found 48.1% prevalence of MS and the serum levels of CRP were significantly higher in patients with COPD and MS compared to those without the syndrome: 7.4 (3.14 – 11. 54) mg/ml vs 4.06 (2.64 – 6.93) mg/ml, p=0.006.

Conclusion: The present study suggests high prevalence of CVD comorbidities in COPD patients and association with the disease severity. Metabolic syndrome is a common comorbidity and is associated with increased inflammatory response.

Open access
Atherogenic Impact of Homocysteine: Can HMG-CoA Reductase Inhibitors Additionally Influence Hyperhomocysteinaemia?

Abstract

The strong association among the risk of coronary artery diseases (CAD), high levels of LDL-C and low levels of HDLC is well established. Hyperhomocysteinaemia (HHcy) is an independent risk factor for cardiovascular disease (CVD) and causes endothelial dysfunction, a hallmark of atherosclerosis. In this study, we ascertained the influence of statins on the atherogenic index, as an indicator and a significant adjunct for predicting atherosclerosis in hyperhomocysteinaemic male Wistar albino rats. For 4 weeks, the animals were fed with one of the following diets (Mucedola SRL., Milan, Italy): standard rodent chow; a diet enriched in methionine with no deficiency in B vitamins or a diet enriched in methio-nine and deficient in B vitamins. The animals were simultaneously exposed to a pharmacology treatment with atorvastatin at dose of 3 mg/kg/day i.p. or simvastatin, at dose of 5 mg/kg/day i.p. We measured weight gain, food intake, and FER and determined the concentrations of biochemical parameters of dyslipidaemia (TC, TGs, LDL-C, VLDL-C, and HDL-C), AI, and CRR. A histopathological examination was conducted on portions of the right and left liver lobes from each animal. A connection between Hhcy and dyslipidaemia was indicated by the findings of biochemical and histological analyses, suggesting that Hhcy was a pro-atherogenic state. An improvement in the lipid profile along with a decrease in the atherogenic index by statins suggests that atorvastatin and simvastatin could be useful antiatherogenic agents, with protective activities during hyperhomocysteinaemia.

Open access