Theoretical Study of Cyanidin-Resveratrol Copigmentation by the Functional Density Theory.

Anthocyanins are colored water-soluble plant pigments. Upon consumption, anthocyanins are quickly absorbed and can penetrate the blood-brain barrier (BBB). Research based on population studies suggests that including anthocyanin-rich sources in the diet lowers the risk of neurodegenerative diseases. The copigmentation caused by copigments is considered an effective way to stabilize anthocyanins against adverse environmental conditions. This is attributed to the covalent and noncovalent interactions between colored forms of anthocyanins (flavylium ions and quinoidal bases) and colorless or pale-yellow organic molecules (copigments). The present work carried out a theoretical study of the copigmentation process between cyanidin and resveratrol (CINRES). We used three levels of density functional theory: M06-2x/6-31g+(d,p) (d3bj); ωB97X-D/6-31+(d,p); APFD/6-31+(d,p), implemented in the Gaussian16W package. In a vacuum, the CINRES was found at a copigmentation distance of 3.54 Å between cyanidin and resveratrol. In water, a binding free energy ∆G was calculated, rendering -3.31, -1.68, and -6.91 kcal/mol, at M06-2x/6-31g+(d,p) (d3bj), ωB97X-D/6-31+(d,p), and APFD/6-31+(d,p) levels of theory, respectively. A time-dependent density functional theory (TD-DFT) was used to calculate the UV spectra of the complexes and then compared to its parent molecules, resulting in a lower energy gap at forming complexes. Excited states' properties were analyzed with the ωB97X-D functional. Finally, Shannon aromaticity indices were calculated and isosurfaces of non-covalent interactions were evaluated.

The Incidence of Alcohol Use Disorders during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has introduced a myriad of challenges to healthcare systems and public health policies across the globe. Individuals with alcohol use disorders are at peaked risk due to mental, socio-demographic, and economic factors leading to hindered mental health service access, misinformation and adherence. METHODS: Keywords including "alcohol use", "death", "hand sanitizer", "overdose" and "COVID-19" were used to obtain 8 media reports for case analysis. A review of 34 manually extracted records were also conducted using PubMed, MEDLINE, Scopus, and the Embase database with no time and language restrictions. RESULTS: A total of 2,517 individuals with alcohol overdose across the United States, India, Canada, and Iran were presented. The majority of cases were male, ages 21-65. Common contributors were linked to socio-economic changes, disruption to mental health services, and physical isolation. CONCLUSION: While original studies are essential to evaluate the etiologies of alcohol use and misuse during pandemics, the dissemination of misinformation must be curbed by directing vulnerable individuals towards accurate information and access to mental health services.

Forgiveness: protecting medical residents from the detrimental relationship between workplace bullying and wellness.

Bullying of medical residents is associated with numerous negative psychological and physiological outcomes. As bullying within this demographic grows, there is increased interest in identifying novel protective factors. Accordingly, this research investigated whether interpersonal forgiveness buffers the relationship between two forms of workplace bullying and indices of well-being. Medical residents (N = 134, 62% males) completed measures assessing person and work-related bullying victimization, dispositional forgiveness, and depressive symptoms and underwent a series of cardiovascular assessments during which cardiovascular reactivity was induced by a 3-min serial subtraction math task. It was hypothesized that the tendency to forgive would be negatively related to bullying victimization and that forgiveness would reduce the association of bullying with psychological distress (i.e. depressive symptoms), cognition errors (i.e. incorrect serial subtraction computations), and exaggerated cardiovascular reactivity and recovery. Findings show that forgiveness reduced the harmful relationship between the two forms of workplace bullying and depressive symptoms, serial subtraction errors, and cardiovascular reactivity and recovery for systolic blood pressure (SBP). Study results suggest that forgiveness may serve as an effective means for reducing the outcomes of bullying for medical residents. Implications for forgiveness interventions are discussed. Lay summary This research demonstrated that forgiveness reduced the harmful relationship between bullying victimization and negative outcomes (i.e. depressive symptoms, subtraction errors, and exaggerated cardiovascular reactivity and recovery for SBP) in medical residents. This study suggests that forgiveness may serve as a protective factor and provide an effective means for reducing the negative association between workplace bullying and negative outcomes.

Minimizing transrectal prostate biopsy-related infections; A prospective randomized trial of povidone-iodine intrarectal cleaning versus formalin needle disinfection.

INTRODUCTION: Transrectal prostate biopsies are associated with post biopsy infection and sepsis. We compared the efficacy of povidone-iodine rectal disinfection versus formalin needle disinfection in preventing post biopsy infection among patients undergoing transrectal ultrasound-guided prostate biopsy. METHODS: Patients scheduled to undergo ultrasound-guided transrectal prostate biopsy (n = 621) over 20 months were randomized into 2 groups to receive either povidone-iodine intrarectal disinfection or formalin disinfection of needle after each core. These were compared to assess which methodology better prevented postprocedure infection. Statistical analysis were used to identify independent factors promoting infections. RESULTS: Two hundred and ninety-eight patients from povidone-iodine intrarectal disinfection were compared with 300 from formalin needle disinfection group. Formalin needle disinfection was associated with significantly more infections (P = 0.02). Escherichia coli was the dominant pathogen, with >50% of cases being quinolone resistant. Type of disinfection (P = 0.002), BMI (P = 0.001), chronic prostatitis (P = 0.002), and diabetes mellitus (P = 0.01) were independent predictors of infections. BMI at 28.95 kg/m2 provided the best predictive cut-off point for infections, irrespective of method of disinfection. Area under the curve for all these parameters together was 0.91. CONCLUSIONS: We conclude that along with oral cephalosporin prophylaxis, povidone-iodine intrarectal disinfection is a superior to formalin needle disinfection alone in preventing post biopsy infection. Patients with BMI >28.95 kg/m2 should be considered at a higher risk for infections.

Self-regulatory biofeedback training: an intervention to reduce school burnout and improve cardiac functioning in college students.

With the detrimental relationship between school burnout and physiological and cognitive functioning now well documented, interventions to ameliorate school burnout symptomology are needed. This study examined the effectiveness of a self-regulatory biofeedback intervention program (Heart Rate Variability Coherence Biofeedback Training [HRVCB]) in contrast to a protocol demonstrated to produce cognitive and physiological improvements (a high intensity interval training protocol [HIIT]) as well as a wait-list control condition at decreasing school burnout in an American collegiate sample (N = 90). Intervention training was conducted over a 4-week span (three sessions per week) with accompanying baseline and post-intervention assessments. In addition to measurements of school burnout and negative affect (depression and anxiety), intervention influences on cognition (via a serial subtraction task) and physiology (hemodynamics, electrocardiography, and a submaximal cardiorespiratory fitness test) were explored. Findings indicate HRVCB training significantly decreased school burnout and increased mathematical performance from pre- to post-intervention measurement. These changes did not occur for HIIT or waitlist participants. Brachial and aortic systolic blood pressure decreased pre to post-intervention for HRVCB but not HIIT or waitlist participants. Cardiovascular fitness (VO2max) improved pre to post-intervention for HIIT but not HRVCB or waitlist participants. Also, both HRVCB and HIIT training participants decreased heart rate from pre to post-intervention but not waitlist participants. Finally, all participants decreased cardiac sympathovagal tone from pre to post-intervention. These findings provide evidence that HRVCB training programs can decrease school burnout as well as improve components associated with cardiac health. Study limitations and directions for future research are discussed.

Pathogenesis of depression- and anxiety-like behavior in an animal model of hypertrophic cardiomyopathy.

Cardiovascular dysfunction is highly comorbid with mood disorders, such as anxiety and depression. However, the mechanisms linking cardiovascular dysfunction with the core behavioral features of mood disorder remain poorly understood. In this study, we used mice bearing a knock-in sarcomeric mutation, which is exhibited in human hypertrophic cardiomyopathy (HCM), to investigate the influence of HCM over the development of anxiety and depression. We employed behavioral, MRI, and biochemical techniques in young (3-4 mo) and aged adult (7-8 mo) female mice to examine the effects of HCM on the development of anxiety- and depression-like behaviors. We focused on females because in both humans and rodents, they experience a 2-fold increase in mood disorder prevalence vs. males. Our results showed that young and aged HCM mice displayed echocardiographic characteristics of the heart disease condition, yet only aged HCM females displayed anxiety- and depression-like behaviors. Electrocardiographic parameters of sympathetic nervous system activation were increased in aged HCM females vs. controls and correlated with mood disorder-related symptoms. In addition, when compared with controls, aged HCM females exhibited adrenal gland hypertrophy, reduced volume in mood-related brain regions, and reduced hippocampal signaling proteins, such as brain-derived neurotrophic factor and its downstream targets vs. controls. In conclusion, prolonged systemic HCM stress can lead to development of mood disorders, possibly through inducing structural and functional brain changes, and thus, mood disorders in patients with heart disease should not be considered solely a psychologic or situational condition.-Dossat, A. M., Sanchez-Gonzalez, M. A., Koutnik, A. P., Leitner, S., Ruiz, E. L., Griffin, B., Rosenberg, J. T., Grant, S. C., Fincham, F. D., Pinto, J. R. Kabbaj, M. Pathogenesis of depression- and anxiety-like behavior in an animal model of hypertrophic cardiomyopathy.

School burnout and heart rate variability: risk of cardiovascular disease and hypertension in young adult females.

Emerging research documents the relationship between school burnout and some indicators of increased cardiovascular risk. Indicators of cardiovascular functioning assessed via ambulatory blood pressure and heart rate variability (HRV) have not been thoroughly explored in this research domain. Therefore, the current study examined relationships between school burnout and indicators of cardiac functioning via 24 h ambulatory blood pressure (BP) and electrocardiogram monitoring in a sample of young adult female undergraduates (N = 88). Two hypotheses were tested: (1) that independent of related negative affective symptomology (depression and anxiety), increased school burnout would be related to greater systolic and diastolic BP, higher low frequency (LF) HRV and lower very low frequency (VLF) HRV, and (2) that lower VLF would be related to greater school burnout independently of LF HRV. Hierarchical multiple regression analyzes showed that school burnout was significantly related to elevated ambulatory BP (systolic and diastolic) and HRV markers of increased cardiac sympathovagal tone. These findings support the hypotheses and suggest that school burnout might be implicated in the development of pre-hypertension or early cardiovascular disease. Study limitations and the need for future longitudinal research are discussed.

Protocol for the Incorporation of γ-Amino Acids into Peptides: Application to (-)-Shikimic Acid Based 2-Amino-Methylcyclohexanecarboxylic Acids.

The first example of a new protocol for the incorporation of γ-amino acids into peptides is reported. It involved a shikimic acid based stereoselective synthesis polyhydroxylated-2-nitromethylcyclohexanecarboxylic acids, which were directly incorporated into peptides.

The Effects of a 12-Week Combined Exercise Training Program on Arterial Stiffness, Vasoactive Substances, Inflammatory Markers, Metabolic Profile, and Body Composition in Obese Adolescent Girls.

PURPOSE: Childhood and adolescent obesity is a major international public health crisis. It is crucial to prevent the negative effects of obesity at an early age by implementing appropriate lifestyle interventions, such as exercise training. We evaluated the effects of a combined resistance and aerobic exercise training (CET) regimen on arterial stiffness, vasoactive substances, inflammatory markers, metabolic profile, and body composition in obese adolescent girls. METHODS: A total of 30 obese adolescent girls were randomly assigned to a CET (n = 15) or a control group (n = 15). The CET group trained for 3 days per week. Plasma nitric oxide, endothelin-1, C-reactive protein, arterial stiffness, glucose, insulin, the adiponectin/leptin ratio, and body fat were measured before and after 12 weeks. RESULTS: There were significant increases (P < .05) in nitric oxide (4.0 µM) and adiponectin/leptin ratio (0.33); and decreases (P < .05) in arterial stiffness (-1.0 m/s), C-reactive protein (-0.5 mg/L), glucose (-1.2 mmol/L), insulin (-17.1 µU/mL), and body fat (-3.6%) following CET compared with control. There were no significant changes in endothelin-1 after CET or control. CONCLUSIONS: The findings of this study indicate that CET improves arterial stiffness, nitric oxide, and inflammatory and metabolic markers in obese adolescent girls. CET may have important health implications for the prevention of atherosclerosis at an early age.

Effectiveness of Tai Chi on Cardiac Autonomic Function and Symptomatology in Women With Fibromyalgia: A Randomized Controlled Trial.

The present study examined the effects of a 12-week Tai Chi (TC) training regimen on heart rate variability (HRV), symptomatology, muscle fitness and body composition in women with fibromyalgia. Participants were randomly assigned to either a TC training group (n = 18) or a control group (n = 19). HRV, symptomatology, muscle fitness and body composition were measured before and after 12 weeks. There were significant decreases (p < 0.05) in sympathovagal balance (LnLF/LnHF), sympathetic tone (LnLF, nLF), pain, and fatigue, and significant increases (p < 0.05) in parasympathetic tone (LnHF, nHF), strength and flexibility following TC compared with no changes after control. The changes in LnLF and LnLF/LnHF were correlated with changes in pain. There were no significant changes in HR, sleep quality and body composition after TC or control. TC may be an effective therapeutic intervention for improving sympathovagal balance, pain, fatigue, strength and flexibility in women with fibromyalgia.

Dispositional self-control: relationships with aerobic capacity and morning surge in blood pressure.

The psychological, behavioral and psychosocial implications of self-control are well established, but relatively little is known about its implications for physical health. This study examined the association between self-control and two important indicators of cardiovascular risk: morning blood pressure surge (MBPS) and maximum oxygen consumption (VO2max). Undergraduate students (N = 78) completed a measure of dispositional self-control (Brief Self-Control Scale), participated in a 24-h ambulatory assessment of heart rate (HR) and blood pressure (BP), and completed the YMCA Cycle Ergometer Submaximal Test. Regression analyzes yielded a significant positive relationship between self-control and VO2max. Results also indicated a significant negative association between self-control and MBPS, independent of average 24-h blood pressure and VO2max scores. These findings expand our understanding of the relationship between dispositional self-control and MBPS. Study limitations and directions for future research are discussed.

Impact of a motivated performance task on autonomic and hemodynamic cardiovascular reactivity.

Motivated performance (MP) tasks include mental stressors characterized by a high degree of motivation, individual engagement, and sympathetic overstimulation. It is therefore important to document the independent influence of motivation apart from engagement on markers of cardiovascular autonomic modulation, including vasomotor tone (low-frequency systolic blood pressure, LFSBP), blood pressure homeostasis (baroreflex sensitivity, BRS), and myocardial oxygen consumption (rate pressure product, RPP). Accordingly, an arithmetic task (AT) was used to manipulate motivation to evaluate its impact on cardiovascular reactivity. Forty-two young adults (Mage = 20.21 years, SD = 2.09) qualified for the study. After a 10-min resting period, electrocardiogram and finger beat-to-beat blood pressure were recorded at three distinct 5-min stages: baseline (BASE), AT, and recovery (REC). Prior to AT initiation, participants were randomized into two groups based on directions stating that the AT task was either designed to be entertaining and fun (low MP, LMP) or a test diagnostic of one's intelligence (high MP, HMP). Independent of task engagement ratings, motivation to complete the AT task as well as solution success was significantly greater in the HMP than the LMP condition. Regarding physiological parameters, two (LMP vs. HMP) × three (BASE, AT, REC) repeated measures ANOVAs revealed no significant baseline differences but a significant higher order interaction indicating that in comparison to LMP, individuals in the HMP condition had significantly higher vasomotor tone and myocardial oxygen consumption but not BRS. Greater motivation during a performance task may provide the substrate for the development of adverse cardiovascular events by increasing sympathetic activity and ultimately increasing myocardial oxygen demand which could lead to acute coronary syndromes.

Understanding the physiology of mindfulness: aortic hemodynamics and heart rate variability.

Data were collected to examine autonomic and hemodynamic cardiovascular modulation underlying mindfulness from two independent samples. An initial sample (N = 185) underwent laboratory assessments of central aortic blood pressure and myocardial functioning to investigated the association between mindfulness and cardiac functioning. Controlling for religiosity, mindfulness demonstrated a strong negative relationship with myocardial oxygen consumption and left ventricular work but not heart rate or blood pressure. A second sample (N = 124) underwent a brief (15 min) mindfulness inducing intervention to examine the influence of mindfulness on cardiovascular autonomic modulation via blood pressure variability and heart rate variability. The intervention had a strong positive effect on cardiovascular modulation by decreasing cardiac sympathovagal tone, vasomotor tone, vascular resistance and ventricular workload. This research establishes a link between mindfulness and cardiovascular functioning via correlational and experimental methodologies in samples of mostly female undergraduates. Future directions for research are outlined.

Long term ablation of protein kinase A (PKA)-mediated cardiac troponin I phosphorylation leads to excitation-contraction uncoupling and diastolic dysfunction in a knock-in mouse model of hypertrophic cardiomyopathy.

The cardiac troponin I (cTnI) R21C (cTnI-R21C) mutation has been linked to hypertrophic cardiomyopathy and renders cTnI incapable of phosphorylation by PKA in vivo. Echocardiographic imaging of homozygous knock-in mice expressing the cTnI-R21C mutation shows that they develop hypertrophy after 12 months of age and have abnormal diastolic function that is characterized by longer filling times and impaired relaxation. Electrocardiographic analyses show that older R21C mice have elevated heart rates and reduced cardiovagal tone. Cardiac myocytes isolated from older R21C mice demonstrate that in the presence of isoproterenol, significant delays in Ca(2+) decay and sarcomere relaxation occur that are not present at 6 months of age. Although isoproterenol and stepwise increases in stimulation frequency accelerate Ca(2+)-transient and sarcomere shortening kinetics in R21C myocytes from older mice, they are unable to attain the corresponding WT values. When R21C myocytes from older mice are treated with isoproterenol, evidence of excitation-contraction uncoupling is indicated by an elevation in diastolic calcium that is frequency-dissociated and not coupled to shorter diastolic sarcomere lengths. Myocytes from older mice have smaller Ca(2+) transient amplitudes (2.3-fold) that are associated with reductions (2.9-fold) in sarcoplasmic reticulum Ca(2+) content. This abnormal Ca(2+) handling within the cell may be attributed to a reduction (2.4-fold) in calsequestrin expression in conjunction with an up-regulation (1.5-fold) of Na(+)-Ca(2+) exchanger. Incubation of permeabilized cardiac fibers from R21C mice with PKA confirmed that the mutation prevents facilitation of mechanical relaxation. Altogether, these results indicate that the inability to enhance myofilament relaxation through cTnI phosphorylation predisposes the heart to abnormal diastolic function, reduced accessibility of cardiac reserves, dysautonomia, and hypertrophy.

School burnout: increased sympathetic vasomotor tone and attenuated ambulatory diurnal blood pressure variability in young adult women.

Two studies examined autonomic and cardiovascular functioning that may link school burnout to cardiovascular risk factors in young healthy adult females. Study 1 (N = 136) investigated whether school burnout was related to resting values of blood pressure (BP) and blood pressure variability (BPV) through laboratory beat-to-beat BP assessment. Study 2 (N = 94) examined the link between school burnout and diurnal BPV through ambulatory BP monitoring. Controlling for anxiety and depressive symptomatology, school burnout demonstrated strong positive relationships with indices of cardiac sympathovagal tone, sympathetic vasomotor tone, inefficient myocardial oxygen consumption, increased 24-h ambulatory heart rate and BP, blunted BP diurnal variability, and increased arterial stiffness. These studies establish cardiovascular biomarkers of school burnout and suggest that even in a seemingly healthy sample school burnout may predispose females to increased cardiovascular risk. Several future lines of research are outlined.

A brief review: the implications of iron supplementation for marathon runners on health and performance.

The marathon is considered one of the most demanding endurance events, imposing an enormous amount of physiological stress on bodily structures, the metabolic machinery, and organ systems. Scientific evidence has conclusively shown that marathoners are in need of special nutritional strategies to maintain performance and health. Indeed, among competitive athletes, marathoners are at greater risk to develop anemia, bone mineral density loss, immunosuppression, and other clinical syndromes that may affect performance. Inadequate dietary intake of the micronutrient iron has been identified as one key factor in the development of the above mentioned anomalies. In fact, iron is one of the few nutrients recommended as a supplement by the American College of Sports Medicine (ACSM), the Academy of Nutrition and Dietetics (AND), and Dietitians of Canada. Therefore, the aim of this review article is to discuss the role of iron on the marathoner's health and performance. Special emphasis will be given to the physiological mechanisms accounting for the additional iron need in this group of athletes and the nutritional strategies intended to counteract iron deficiency.

School burnout and cardiovascular functioning in young adult males: a hemodynamic perspective.

This study investigated aortic and brachial hemodynamic functioning that may link school burnout to cardiovascular risk factors. Methodological improvements from previous research were implemented including (1) statistical control of depressive and anxiety symptoms (2) resting, stress-induced and cardiac recovery condition comparisons and (3) use of pulse wave analysis. Forty undergraduate young adult males completed self-report measures of school burnout, trait anxiety and depressive symptoms. Participants then completed a protocol consisting of a 10-min seated rest, 5-min baseline (BASE), 3-min cold pressor test (CPT) and a 3-min recovery period (REC). Indices of brachial and aortic hemodynamics were obtained by means of pulse wave analysis via applanation tonometry. Controlling for anxiety and depressive symptoms, planned contrasts identified no differences in cardiovascular parameters at BASE between participants in burnout and non-burnout groups. However, negative changes in hemodynamic indices occurred in burnout participants at CPT and REC as evidenced by increased aortic and brachial systolic and diastolic blood pressures, increased left ventricular work and increased myocardial oxygen consumption. Findings suggest that school burnout symptoms are associated with cardiac hyperactivity during conditions of cardiac stress and recovery and therefore may be associated with the early manifestations of cardiovascular disease. Future studies are suggested to reveal underlying autonomic mechanisms explaining hemodynamics functioning in individuals with school burnout symptomatology.

Impact of acute whole-body cold exposure with concurrent isometric handgrip exercise on aortic pressure waveform characteristics.

PURPOSE: Adverse cardiovascular events are more prevalent during winter and in people that exercise/work in cold temperatures. Since pulse wave analysis indices, aortic systolic blood pressure (ASBP), augmentation index (AIx), and wasted left ventricular pressure energy (ΔE w), are stronger predictors of cardiovascular events and myocardial performance than brachial blood pressure (BP), we sought to evaluate the aortic hemodynamic responses during cold exposure with concurrent isometric handgrip exercise (IHG). METHODS: In a crossover randomized fashion, 20 healthy normotensive men (22.1 ± 2 years) were evaluated, by means of radial applanation tonometry, inside an environmental chamber in the supine position at cold (4 °C) and temperate (24 °C) conditions. Following a 30-min equilibration period, measurements were performed during pre-exercise baseline (REST), in the last 90 s of a 3-min IHG at 30% maximal voluntary contraction, and 3 min immediately after the finalization of IHG bout (recovery, REC). RESULTS: At REST, brachial systolic BP (BSBP) (12 ± 2 mmHg; P < 0.01), ASBP (14 ± 3 mmHg; P < 0.01), AIx (11 ± 3%; P < 0.05), and ΔE w (737 ± 128 dynes s/cm(2); P < 0.01) were higher in 4 °C compared to 24 °C trial. Compared to REST, IHG significantly increased (P < 0.01) BSBP, ASBP, AIx, and ΔEw, while BSBP and ASBP remained elevated during REC (P < 0.01). Compared to REST and temperate, AIx (11 ± 3%) and ΔE w (793 ± 145 dynes s/cm(2); P < 0.01) were higher during IHG and cold, while BSBP and ASBP were elevated during REC and cold. AIx and ΔE w returned to REST values in both trials, but AIx (11 ± 4%; P < 0.05) and ΔE w (656 ± 132 dynes s/cm(2); P < 0.05) were higher in the cold. CONCLUSIONS: Cold exposure with concurrent IHG induces a significant increase in aortic hemodynamic markers, which may evoke adverse cardiovascular events.

Effective Nasal Disinfection as an Overlooked Strategy in Our Fight against COVID-19.

Although the recent advent of a vaccine and other therapeutic aids in our fight against COVID-19 has brought us a step closer to controlling the pandemic, our fight is far from over. Handwashing, masks, and social distancing practices are considered reasonable measures to control the spread of the disease have been well accepted by government officials and public health officials despite scarce and conflicting scientific evidence. Taking into consideration the aforementioned measures, there is an additional perhaps overlooked practice that warrants our attention-nasal disinfection and hygiene.

Noninvasive central hemodynamic monitoring in the primary care setting: improving prevention and management of cardiovascular diseases.

Background: Although cardiovascular disease (CVD) has markedly declined since the early 1960s due to medical advances and better management, this condition persists as the most critical and preventable cause of death in the US. For that reason, the identification and application of more sensitive, specific, validated, and noninvasive biomarkers of cardiovascular functioning in the primary care setting for the early identification of CVD risk at the subclinical level are warranted. Aim: The goal of the present review is twofold: first, to familiarize the primary care practitioner with noninvasive aortic hemodynamic parameters, including how these could be integrated into primary care services and patient management, and second, to propose a model for earlier detection of CVD based on the noninvasive hemodynamic parameters in the primary care setting. Relevance for Patients: Implementation of noninvasive hemodynamic monitoring in a primary care setting could help in the identification of heart disease risk at the early onset thus preventing the need for expensive treatment or death at later stages.