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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.

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Prevention of cardiovascular disease and eating behaviour in postmenopausal women

of hypertension. J Clin Hypertens. 2008;10(7):3-11. 18. He FJ, Li J, MacGregor GA. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens. 2002;16(11):761-70. 19. Poggio R, Gutierrez L, Matta MG, et al. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. 20. Gepner A, Ramamurthy R, Krueger DC, et al. A prospective randomized controlled trial of the

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The “ECG modifications induced by the disturbance of the circadian rhythm in night-shift workers (ECGNoct)” study protocol

, O’Brien CS, Ng KT, Rajaratnam SM. Validation of a questionnaire to screen for shift work disorder. Sleep.2012;35:1693–1703. 19. European Society of Cradiology.Score risk charts. https://www.escardio.org/Education/Practice-Tools/CVD-prevention-toolbox/SCORE-Risk-Charts,pdf dowloaded 10.02.2019. 20. Prineas R, Crow R, Blackburn H. The Minnesota Code Manual of Electrocardiographic Findings. 2nd edition, London: Springer-Verlag; 2010. 21. Sagie A, Larson MG, Goldberg RJ, Bengtson JR, Levy D. An improved method for adjusting the QT interval for

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Assessment of Cardiovascular Risk in Hospitalized Patients with Hypertension Aged 40 and Over

Summary

The aim of the cross-sectional study was to estimate the absolute 10-year risk for fatal cardiovascular disease (CVD) in patients with hypertension by Systematic Coronary Risk Estimation (SCORE). The study was carried out in 2016 as part of Project No 4/2016. Ninety-one patients aged 40-89 years were included. The mean age of the sample was 66.0±11.0, and 44.0% were males. Information of the patients’ risk profile included about age, gender, blood pressure, smoking and total cholesterol. The patients with hypertension were stratified according to a 10-year absolute risk of CVD. Data were processed by Statistical Package for Social Science versions 19.0 (SPSS.v.19.0). Over two-thirds of the patients had 1 stage hypertension (31.9%) and 2 stage hypertension (37.4%). Median systolic blood pressure on admission to the clinics was 160 mg Hg, and median diastolic blood pressure was 90 mm Hg. Total serum cholesterol values exceeded 4.9 mmol/L in 64.0% of the patients. Smokers accounted for about one-fourth of the patients, most of them having smoked for 40 years. The mean number of risk factors for CVD was 3.0. Over 65% of the patients were found to be at a very high 10-year absolute risk of fatal CVD by SCORE. Cardiovascular risk assessment has important role in prevention of morbidity, premature death and disability of CVD.

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Plasma Homocysteine Level And C677T Polymorphism In MTHFR Gene In Patients With Acute Coronary Syndrome

Summary

Cardiovascular diseases (CVD) of atherosclerotic origin and accompanying complications are a major cause of mortality in the world and Ukraine, in particular. Endothelial dysfunction is the key cause of atherosclerosis and atherothrombosis. One of the causes of endothelial dysfunction is hyperhomocysteinemia that may occur on the background of MTHFR (methylenetetrahydrofolate reductase) mutation.

Thus, the goal of the study was to investigate the interrelation between homocysteine (Hc) level and MTHFR polymorphism in patients with acute coronary syndrome (ACS).

161 patients with ischemic heart disease and ACS have been examined. The control group comprised 87 healthy individuals. Homocysteine level was the highest in the patients having ACS with ST-segment elevation and complicated course, and was 1.8 times higher than Hc level in the control group. The patients with the most severe ACS course comprised 27 % of homozygotes for the major allele C and 41 % of homozygotes for the minor allele T. Comparing the distribution of MTHFR gene C677T polymorphism in patients with ACS that were stratified by plasma Hc level, we observed a statistically significant association, P < 0.030 by chi-square test. We confirmed that these patients had a high T/T genotype frequency of MTHFR C677T polymorphism. The obtained data proved the association of T/T genotype of MTHFR C677T polymorphism with increased Hc level as well as ACS severity.

Open access
The contribution of paraoxonase 1 and myeloperoxidase to HDL-cholesterol functionality

Summary

The purpose of this study was to analyse the scientific evidence concerning the effects of two enzymes – paraoxonase 1 and myeloperoxidase – on the functions of HDL-cholesterol. It is well documented that disturbed circulating lipoproteins (a high total and high LDL-cholesterol, and low HDL-cholesterol) bring about atherosclerosis and an increased risk of cardiovascular disease (CVD) which is recognised as the main cause of death all around the world. In consequence, numerous studies have focused on procedures which will improve the plasma lipoproteins profile by decreasing the total cholesterol and the LDL-cholesterol (LDL-C) and increasing the HDL-cholesterol (HDL-C). However, the anti-atherogenic role of HDL-C has been challenged in studies showing that genetically elevated HDL-cholesterol does not offer protection against CVD. Moreover, it has been found that raising the circulating HDL-cholesterol fails to reduce atherosclerosis. The doubts concerning the protective role of HDL-C have been supported by in vitro studies which indicate that the HDL-C from patients with atherosclerosis does not have a protective action, but does stimulate inflammation and free radical synthesis. The above data suggests that HDL-C, commonly recognised as protective against atherosclerosis, in some circumstances becomes pro-atherogenic, and is thus dysfunctional. Our review focuses on two enzymes – paraoxonase 1 (PON1) and myeloperoxidase (MPO) – which markedly affect the properties of HDL-C and contribute to its anti – or pro-atherogenic activity. Moreover, the effects of the diet and physical activity on PON1 and MPO are summarised with respect to the HDL-C functionality.

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Omega-3 fatty acids and exercise: a review of their combined effects on body composition and physical performance

enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial. Ann. Surg. 249:355-363. Saynor R., V. Derel, T. Gillott (1984) The long-term effect of dietary supplementation with fish lipid concentrate on serum lipids, bleeding time, platelets and angina. Atherosclerosis 50:3-10. Schacky, von C. (2007) n-3 PUFA in CVD: influence of cytokine polymorphism. Proc. Nutr. Soc. 66:166-170. Schacky

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