Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 15.770
Filtrar
1.
Expert Opin Investig Drugs ; 29(2): 191-196, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31928475

RESUMEN

Introduction: NASH and type 2 diabetes (T2D) are clinical definitions that overlap and result from metabolic dysfunction caused by over-nutrition relative to metabolic need. This volume details drug development programs aimed at specific NASH pathology with a focus on liver outcomes; this commentary suggests a metabolic approach that should not be overlooked based on a new understanding of insulin sensitizers.Areas covered: The overlap of NASH and T2D with respect to metabolic syndrome is discussed in the context of new understandings of insulin sensitizers. Adverse clinical outcomes in subjects with advanced NAFLD (e.g. NASH) and advanced metabolic dysfunction (e.g., T2D) are primarily due to cardiovascular issues. Clinical evidence suggests that insulin resistance and hyperinsulinemia predict adverse cardiovascular outcomes. NALFD/NASH significantly contributes to insulin resistance and hyperinsulinemia. A new insulin sensitizer that targets the newly identified mitochondrial pyruvate carrier could provide an approach.Expert opinion: A metabolic approach is needed for the treatment of NASH. Clinical studies are underway to determine whether a new insulin sensitizer that targets pyruvate metabolism can impact NASH, T2D, and cardiovascular disease. A broader view of metabolic disease may provide a more assessable way to track therapeutic benefit.


Asunto(s)
Enfermedades Cardiovasculares/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , Animales , Enfermedades Cardiovasculares/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Desarrollo de Medicamentos , Humanos , Resistencia a la Insulina , Síndrome Metabólico/tratamiento farmacológico , Síndrome Metabólico/fisiopatología , Afecciones Crónicas Múltiples , Enfermedad del Hígado Graso no Alcohólico/fisiopatología
2.
Adv Exp Med Biol ; 1216: 87-97, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31894550

RESUMEN

Frailty and cardiovascular disease (CVD) are both highly prevalent in older adults. Cardiovascular disease has been identified as the most frequent cause of death, while frailty has been identified as one of geriatric giants characterized by decreased physiological reserves and increased vulnerability. However, the exact pathobiological links between the two conditions have not been fully elucidated. Consequently, we observe a relevant difficulty not only in accurately defining cardiovascular risk in vulnerable elderly patients (and the other way around), but also a lack of consensus regarding CVD management in the very old. Nowadays, considering the enormous technical innovation, many elderly patients, if appropriately selected, could be eligible even for the most complex treatments, including invasive cardiological procedures. Identification of frail patients at risk of negative outcomes can allow the customization of therapeutic interventions in elderly patients with CVD, allowing the elderly who can benefit from them to undergo even invasive procedures and avoiding futile or dangerous treatments for the most vulnerable patients. A large number of tools and definitions for assessing frailty have been proposed; different scales and assessment tools can be useful for different purposes, but at present there is no clear indication for their use in CVD. In this chapter, we will describe the main geriatric approach to ascertain frailty, the assessment tools used in patients with cardiovascular diseases, and propose an operational strategy to evaluate frailty and identify patients eligible for pharmacologic or surgical interventions.


Asunto(s)
Enfermedades Cardiovasculares , Anciano Frágil , Evaluación Geriátrica , Anciano , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Humanos , Medición de Riesgo
3.
Rev Esp Cardiol (Engl Ed) ; 73(1): 43-52, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31521574

RESUMEN

INTRODUCTION AND OBJECTIVES: To describe, for the first time, reference values for the cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (BA-PWV), carotid-femoral pulse wave velocity (CF-PWV), and the central augmentation index and to establish their association with cardiovascular risk factors in the Spanish adult population aged 35 to 75 years without cardiovascular disease. METHODS: We conducted a cross-sectional study. Through random sampling stratified by age and sex, we included 501 participants without cardiovascular disease. The mean age was 55.9 years and 50.3% were women. The measurements were taken using the SphigmoCor and Vasera VS-1500 devices. RESULTS: Values for all measures, except those for the central augmentation index, were higher in men and increased with age and blood pressure. The mean values were as follows: CAVI, 8.01±1.44; BA-PWV, 12.93±2.68m/s; CF-PWV, 6.53±2.03 m/s, and central augmentation index, 26.84±12.79. On multiple regression analysis, mean blood pressure was associated with the 4 measures, glycated hemoglobin was associated with all measures except the central augmentation index, and body mass index showed an inverse association with CAVI. The explanatory capacity of age, sex, and mean blood pressure was 62% for BA-PWV, 49% for CF-PWV 49%, 54% for the CAVI, and 38% for the central augmentation index. On logistic regression, hypertension was associated with the CAVI (OR=3.45), VOP-BT (OR=3.44), VOP-CF (OR=3.38) and with the central augmentation index (OR=3.73). CONCLUSIONS: All arterial stiffness measures increased with age. The CAVI and CF-PWV were higher in men and the central augmentation index was higher in women, with no differences in BA-PWV. This study is registered at ClinicalTrials.gov. Identifier NCT02623894.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Vigilancia de la Población , Rigidez Vascular/fisiología , Adulto , Anciano , Índice Tobillo Braquial , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Análisis de la Onda del Pulso , Valores de Referencia , Factores de Riesgo , España/epidemiología
4.
Expert Opin Drug Saf ; 19(1): 59-67, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31795777

RESUMEN

Introduction: The objective of this study was to review the current status of drug-induced hypomagnesemia and its adverse effects on cardiovascular disease (CVD) and hypertension. Since magnesium is a potent vasodilator, which modulates vasomotor tone, peripheral blood flow, and hypertension, its deficiency could have significant cardiovascular and blood pressure (BP) effects.Areas covered: Studies have shown that several factors can contribute to magnesium deficiency including age, diet, disease, and certain drugs such as diuretics and proton-pump inhibitors (PPIs). For an updated perspective of drug-induced hypomagnesemia, a Medline search of the English language literature was conducted between 2010 and 2019 using the terms diuretics, proton-pump inhibitors, hypomagnesemia, cardiovascular disease, hypertension, and 35 pertinent papers were retrieved.Expert opinion: The data showed that magnesium deficiency is difficult to occur since it is plentiful in green leafy vegetables, cereals, nuts, and the drinking water. However, magnesium deficiency can occur with the use of diuretics for the treatment of hypertension and heart failure, or the use of PPIs for the treatment of gastroesophageal reflux disease. Therefore, magnesium deficiency should be detected and treated to prevent the aggravation of hypertension and the onset of CVD and serious cardiac arrhythmias including torsades de points.


Asunto(s)
Diuréticos/efectos adversos , Deficiencia de Magnesio/inducido químicamente , Inhibidores de la Bomba de Protones/efectos adversos , Animales , Arritmias Cardíacas/inducido químicamente , Presión Sanguínea/efectos de los fármacos , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/fisiopatología , Diuréticos/administración & dosificación , Humanos , Hipertensión/etiología , Deficiencia de Magnesio/complicaciones , Deficiencia de Magnesio/diagnóstico , Inhibidores de la Bomba de Protones/administración & dosificación
6.
J Sci Food Agric ; 100(2): 846-854, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-31646650

RESUMEN

BACKGROUND: Pomegranate has antioxidant, cardioprotective and anti-inflammatory properties. We designed a crossover study aimed at determining if consumption of pomegranate juice (PJ) improves lipid profile and oxidative and inflammatory biomarkers of hemodialysis patients. Forty-one hemodialysis patients were randomly assigned to one of two groups: PJ-treated group receiving 100 mL of natural PJ immediately after their dialysis session three times a week and the control group receiving the usual care. After 8 weeks, a 4-week washout period was established and then the role of the groups was exchanged. Lipid profile, blood pressure and oxidative and inflammatory biomarkers were measured before and after each sequence. RESULTS: Based on the results of intention-to-treat analysis, triglycerides were decreased in PJ condition and increased in the controls. Conversely, high-density lipoprotein cholesterol was increased in PJ and decreased in the control group. Total and low-density lipoprotein cholesterol did not significantly change in either condition. Systolic and diastolic blood pressure significantly decreased in PJ condition. Total antioxidant capacity increased in PJ condition (P < 0.001) and decreased in the controls (P < 0.001). Conversely, malondialdehyde and interleukin-6 decreased in PJ (P < 0.001) and increased in the control group (P ≤ 0.001). The changes of these biomarkers were significantly different between the two conditions. CONCLUSIONS: Eight-week PJ consumption showed beneficial effects on blood pressure, serum triglycerides, high-density lipoprotein cholesterol, oxidative stress and inflammation in hemodialysis patients. © 2019 Society of Chemical Industry.


Asunto(s)
Enfermedades Cardiovasculares/metabolismo , Jugos de Frutas y Vegetales/análisis , Insuficiencia Renal Crónica/dietoterapia , Adulto , Anciano , Presión Sanguínea , Enfermedades Cardiovasculares/inmunología , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/prevención & control , Estudios Cruzados , Femenino , Humanos , Masculino , Malondialdehído/metabolismo , Persona de Mediana Edad , Estrés Oxidativo , Diálisis Renal , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/metabolismo , Insuficiencia Renal Crónica/terapia , Triglicéridos/metabolismo
7.
Adv Exp Med Biol ; 1131: 489-504, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31646522

RESUMEN

Store-Operated Ca2+ Entry (SOCE) is an important Ca2+ influx pathway expressed by several excitable and non-excitable cell types. SOCE is recognized as relevant signaling pathway not only for physiological process, but also for its involvement in different pathologies. In fact, independent studies demonstrated the implication of essential protein regulating SOCE, such as STIM, Orai and TRPCs, in different pathogenesis and cell disorders, including cardiovascular disease, muscular dystrophies and angiogenesis. Compelling evidence showed that dysregulation in the function and/or expression of isoforms of STIM, Orai or TRPC play pivotal roles in cardiac hypertrophy and heart failure, vascular remodeling and hypertension, skeletal myopathies, and angiogenesis. In this chapter, we summarized the current knowledge concerning the mechanisms underlying abnormal SOCE and its involvement in some diseases, as well as, we discussed the significance of STIM, Orai and TRPC isoforms as possible therapeutic targets for the treatment of angiogenesis, cardiovascular and skeletal muscle diseases.


Asunto(s)
Calcio , Enfermedades Cardiovasculares , Enfermedades Musculares , Neovascularización Patológica , Calcio/metabolismo , Canales de Calcio , Señalización del Calcio , Enfermedades Cardiovasculares/fisiopatología , Humanos , Transporte Iónico , Enfermedades Musculares/fisiopatología , Neovascularización Patológica/fisiopatología
8.
Nat Med ; 25(12): 1822-1832, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31806905

RESUMEN

Although intermittent increases in inflammation are critical for survival during physical injury and infection, recent research has revealed that certain social, environmental and lifestyle factors can promote systemic chronic inflammation (SCI) that can, in turn, lead to several diseases that collectively represent the leading causes of disability and mortality worldwide, such as cardiovascular disease, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease and autoimmune and neurodegenerative disorders. In the present Perspective we describe the multi-level mechanisms underlying SCI and several risk factors that promote this health-damaging phenotype, including infections, physical inactivity, poor diet, environmental and industrial toxicants and psychological stress. Furthermore, we suggest potential strategies for advancing the early diagnosis, prevention and treatment of SCI.


Asunto(s)
Enfermedad Crónica/epidemiología , Inflamación/fisiopatología , Longevidad/genética , Enfermedades Autoinmunes/etiología , Enfermedades Autoinmunes/fisiopatología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Diabetes Mellitus/etiología , Diabetes Mellitus/fisiopatología , Humanos , Inflamación/complicaciones , Inflamación/epidemiología , Estilo de Vida , Longevidad/fisiología , Neoplasias/etiología , Neoplasias/fisiopatología , Enfermedades Neurodegenerativas/etiología , Enfermedades Neurodegenerativas/fisiopatología , Enfermedad del Hígado Graso no Alcohólico/etiología , Enfermedad del Hígado Graso no Alcohólico/fisiopatología , Insuficiencia Renal Crónica/etiología , Insuficiencia Renal Crónica/fisiopatología , Factores de Riesgo
9.
Mayo Clin Proc ; 94(11): 2230-2240, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31685151

RESUMEN

OBJECTIVE: To investigate the associations of objectively measured cardiorespiratory fitness (CRF) and grip strength (GS) with incident heart failure (HF), a clinical syndrome that results in substantial social and economic burden, using UK Biobank data. PATIENTS AND METHODS: Of the 502,628 participants recruited into the UK Biobank between April 1, 2007, and December 31, 2010, a total of 374,493 were included in our GS analysis and 57,053 were included in CRF analysis. Associations between CRF and GS and incident HF were investigated using Cox proportional hazard models, with adjustment for known measured confounders. RESULTS: During a mean of 4.1 (range, 2.4-7.1) years, 631 HF events occurred in those with GS data, and 66 HF events occurred in those with CRF data. Higher CRF was associated with 18% lower risk for HF (hazard ratio [HR], 0.82; 95% CI, 0.76-0.88) per 1-metabolic equivalent increment increase and GS was associated with 19% lower incidence of HF risk (HR, 0.81; 95% CI, 0.77-0.86) per 5-kg increment increase. When CRF and GS were standardized, the HR for CRF was 0.50 per 1-SD increment (95% CI, 0.38-0.65), and for GS was 0.65 per 1-SD increment (95% CI, 0.58-0.72). CONCLUSION: Our data indicate that objective measurements of physical function (GS and CRF) are strongly and independently associated with lower HF incidence. Future studies targeting improving CRF and muscle strength should include HF as an outcome to assess whether these results are causal.


Asunto(s)
Capacidad Cardiovascular/fisiología , Enfermedades Cardiovasculares/fisiopatología , Fuerza de la Mano/fisiología , Fuerza Muscular/fisiología , Músculo Esquelético/fisiopatología , Enfermedades Cardiovasculares/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aptitud Física/fisiología , Factores de Riesgo , Reino Unido
10.
Methodist Debakey Cardiovasc J ; 15(3): 200-206, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31687099

RESUMEN

Nitric oxide (NO) is continually produced by the enzyme nitric oxide synthase (NOS) and is essential to the control and effectiveness of the cardiovascular system. However, there is a substantial reduction in NOS activity with aging that can lead to the development of hypertension and other cardiovascular complications. Fortunately, NO can also be produced by the sequential reduction of inorganic nitrate to nitrite and then to NO. Nitric oxide from inorganic nitrate supplementation has been found to have the same cardioprotective benefits of NO produced by NOS. Moreover, it can effectively compensate for declining NOS activity due to aging or NOS inhibition by oxidative stress, hypoxia, or other factors. This review covers some of the major cardiovascular regulatory actions of NO and presents evidence that NO from inorganic nitrate supplementation can provide (1) compensation when NOS activity is inadequate, and (2) cardioprotective benefits beyond that provided by a healthy NOS system. In addition, it discusses how to obtain a safe and efficacious range of inorganic nitrate.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Sistema Cardiovascular/efectos de los fármacos , Suplementos Dietéticos , Nitratos/uso terapéutico , Óxido Nítrico/metabolismo , Animales , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/fisiopatología , Sistema Cardiovascular/metabolismo , Sistema Cardiovascular/fisiopatología , Suplementos Dietéticos/efectos adversos , Estado de Salud , Humanos , Nitratos/efectos adversos , Óxido Nítrico Sintasa/metabolismo , Factores de Riesgo , Resultado del Tratamiento
11.
Nat Med ; 25(11): 1753-1760, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31700174

RESUMEN

Chronic kidney disease is common in the general population and associated with excess cardiovascular disease (CVD), but kidney function does not feature in current CVD risk-prediction models. We tested three formulae for estimated glomerular filtration rate (eGFR) to determine which was the most clinically informative for predicting CVD and mortality. Using data from 440,526 participants from UK Biobank, eGFR was calculated using serum creatinine, cystatin C (eGFRcys) and creatinine-cystatin C. Associations of each eGFR with CVD outcome and mortality were compared using Cox models and adjusting for atherosclerotic risk factors (per relevant risk scores), and the predictive utility was determined by the C-statistic and categorical net reclassification index. We show that eGFRcys is most strongly associated with CVD and mortality, and, along with albuminuria, adds predictive discrimination to current CVD risk scores, whilst traditional creatinine-based measures are weakly associated with risk. Clinicians should consider measuring eGFRcys as part of cardiovascular risk assessment.


Asunto(s)
Enfermedades Cardiovasculares/diagnóstico , Tasa de Filtración Glomerular/fisiología , Fallo Renal Crónico/diagnóstico , Insuficiencia Renal Crónica/diagnóstico , Adulto , Anciano , Albuminuria/complicaciones , Albuminuria/diagnóstico , Albuminuria/fisiopatología , Albuminuria/orina , Bancos de Muestras Biológicas , Biomarcadores/sangre , Biomarcadores/orina , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/fisiopatología , Creatinina/metabolismo , Femenino , Humanos , Fallo Renal Crónico/sangre , Fallo Renal Crónico/fisiopatología , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/fisiopatología , Factores de Riesgo
12.
Nat Med ; 25(11): 1761-1771, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31700184

RESUMEN

A sedentary lifestyle, chronic inflammation and leukocytosis increase atherosclerosis; however, it remains unclear whether regular physical activity influences leukocyte production. Here we show that voluntary running decreases hematopoietic activity in mice. Exercise protects mice and humans with atherosclerosis from chronic leukocytosis but does not compromise emergency hematopoiesis in mice. Mechanistically, exercise diminishes leptin production in adipose tissue, augmenting quiescence-promoting hematopoietic niche factors in leptin-receptor-positive stromal bone marrow cells. Induced deletion of the leptin receptor in Prrx1-creERT2; Leprfl/fl mice reveals that leptin's effect on bone marrow niche cells regulates hematopoietic stem and progenitor cell (HSPC) proliferation and leukocyte production, as well as cardiovascular inflammation and outcomes. Whereas running wheel withdrawal quickly reverses leptin levels, the impact of exercise on leukocyte production and on the HSPC epigenome and transcriptome persists for several weeks. Together, these data show that physical activity alters HSPCs via modulation of their niche, reducing hematopoietic output of inflammatory leukocytes.


Asunto(s)
Aterosclerosis/terapia , Enfermedades Cardiovasculares/terapia , Células Madre Hematopoyéticas/metabolismo , Inflamación/terapia , Condicionamiento Físico Animal , Tejido Adiposo/metabolismo , Animales , Aterosclerosis/prevención & control , Enfermedades Cardiovasculares/genética , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/prevención & control , Ejercicio/fisiología , Hematopoyesis/genética , Hematopoyesis/fisiología , Proteínas de Homeodominio/genética , Humanos , Inflamación/fisiopatología , Leucocitos/metabolismo , Leucocitosis/fisiopatología , Leucocitosis/terapia , Ratones , Receptores de Leptina/genética , Conducta Sedentaria , Transcriptoma/genética
13.
Sheng Li Xue Bao ; 71(5): 783-791, 2019 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-31646332

RESUMEN

Circadian rhythms widely exist in living organisms, and they are regulated by the biological clock. Growing evidence has shown that circadian rhythms are tightly related to the physiological function of the cardiovascular system, including blood pressure, heart rate, metabolism of cardiomyocytes, function of endothelial cells, and vasoconstriction and vasodilation. In addition, disruption of circadian rhythms has been considered as one of the important risk factors for cardiovascular diseases, such as myocardial infarction. This review summarizes the recent research advances in the relationship between circadian clock and cardiovascular diseases, hoping to improve treatment strategies for patients with cardiovascular diseases according to the theory of biological clock.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Relojes Circadianos , Ritmo Circadiano , Presión Sanguínea , Células Endoteliales/citología , Frecuencia Cardíaca , Humanos , Miocitos Cardíacos/metabolismo , Vasoconstricción , Vasodilatación
15.
Rev Cardiovasc Med ; 20(3): 153-160, 2019 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-31601089

RESUMEN

Exosomes, nanosized lipid bilayer membranous vesicles, are secreted by a variety of cells and contain protein, lipids, mRNA, miRNA, and signaling molecules that participate in intercellular material transfer and information exchange through binding, fusion or endocytosis. Exosomes mediate the gene expression of target cells and regulate pathological and physiological processes, thereby playing a key role in the occurrence and development of various diseases. Accumulated studies has shown that exosomes hold therapeutic potential though their anti-apoptotic and anti-fibrotic roles. They also have been shown to promote angiogenesis, inhibit ventricular remodeling and improve cardiac function, as well as inhibiting local inflammation and regulating the immune response. As such, exosomes represent a new target for the treatment of cardiovascular diseases. This review summarizes the literature in this field to date, including the basic biological characteristics of exosomes, and new progress in the understanding of the mechanisms of their involvement in immune regulation in cardiovascular diseases. In this way, it servrs as a basis for future research and the development of therapeutic exosomes.


Asunto(s)
Enfermedades Cardiovasculares/inmunología , Sistema Cardiovascular/inmunología , Exosomas/inmunología , Sistema Inmunológico/inmunología , Animales , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/terapia , Sistema Cardiovascular/metabolismo , Sistema Cardiovascular/fisiopatología , Exosomas/metabolismo , Exosomas/trasplante , Humanos , Sistema Inmunológico/metabolismo , Sistema Inmunológico/fisiopatología , Pronóstico , Transducción de Señal
16.
Vasc Health Risk Manag ; 15: 409-418, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31571892

RESUMEN

Introduction: Previous studies have shown that veterans with lower limb amputation have a higher risk for cardiovascular disease (CVD) compared with population-based controls. American veterans who have served in Iraq and Afghanistan with lower limb amputation may be at a similarly higher risk. Patients and methods: The Navel Health Research Center (NHRC) maintains the Expeditionary Medical Encounter Database (EMED) of military personnel who have sustained combat limb amputation or serious limb injury during the conflicts in Iraq and Afghanistan. Department of Veterans Affairs data from 2003 to April 2015 was used to analyze CVD risk factors in this cohort. Veterans with either unilateral (n=442) or bilateral (n=146) lower limb amputation were compared to those with serious lower limb trauma without amputation (n=184). Multivariate regression was used to measure associations between lower limb amputation and CVD risk factors over an average of 8 years of follow-up. Outcomes included mean arterial pressure (MAP), low-density lipoprotein, high-density lipoprotein (HDL), and serum triglycerides (TG). Results: Compared with the limb injury group, those with unilateral lower limb amputation had significantly lower HDL (p<0.05) and higher TG (p<0.05). Those with bilateral lower limb amputation had significantly higher MAP (p<0.05), lower HDL (p<0.01), and higher TG (p<0.001). The prevalence of metabolic syndrome, defined as type 2 diabetes or a constellation of blood pressure and lipid changes consistent with metabolic syndrome, was 8.7%, 14.9%, and 21.9% for limb injury, unilateral amputation, and bilateral amputation groups, respectively. Veterans with bilateral lower limb amputation had a 2.25-increased odds ratio (95% confidence interval 1.19-5.05) of type 2 diabetes or blood pressure and lipid changes consistent with metabolic syndrome compared to those with limb injury. Conclusions: Results suggest that veterans with lower limb amputation have a higher risk for metabolic syndrome. Primary care interventions to manage weight, blood pressure, and lipid levels are fundamental in order to reduce cardiac risk in this relatively young cohort.


Asunto(s)
Amputación/efectos adversos , Enfermedades Cardiovasculares/epidemiología , Extremidad Inferior/irrigación sanguínea , Síndrome Metabólico/epidemiología , Lesiones del Sistema Vascular/cirugía , Salud de los Veteranos , Adulto , Campaña Afgana 2001- , Biomarcadores/sangre , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/fisiopatología , Bases de Datos Factuales , Femenino , Hemodinámica , Humanos , Guerra de Irak 2003-2011 , Lípidos/sangre , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Prevalencia , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Estados Unidos/epidemiología , United States Department of Veterans Affairs , Lesiones del Sistema Vascular/diagnóstico , Lesiones del Sistema Vascular/epidemiología , Lesiones del Sistema Vascular/fisiopatología
17.
Clin Interv Aging ; 14: 1579-1587, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31564840

RESUMEN

Background: Aging leads to structural and functional changes in the vasculature characterized by arterial endothelial dysfunction and stiffening of large elastic arteries and is a predominant risk factor for cardiovascular disease, the leading cause of morbidity and mortality in modern societies. Although exercise reduces the risk of many age-related diseases, including cardiovascular disease, the mechanisms underlying the beneficial effects of exercise on age-related endothelial function fully elucidated. Purpose: The present study explored the effects of exercise on the impaired endothelium-derived hyperpolarizing factor (EDHF)-mediated vasodilation in aged arteries and on the involvement of the transient receptor potential vanilloid 4 (TRPV4) channel and the small-conductance calcium-activated potassium (KCa2.3) channel signaling in this process. Methods: Male Sprague-Dawley rats aged 19-21 months were randomly assigned to a sedentary group or to an exercise group. Two-month-old rats were used as young controls. Results: We found that TRPV4 and KCa2.3 isolated from primary cultured rat aortic endothelial cells pulled each other down in co-immunoprecipitation assays, indicating that the two channels could physically interact. Using ex vivo functional arterial tension assays, we found that EDHF-mediated relaxation induced by acetylcholine or by the TRPV4 activator GSK1016790A was markedly decreased in aged rats compared with that in young rats and was significantly inhibited by TRPV4 or KCa2.3 blockers in both young and aged rats. However, exercise restored both the age-related and the TRPV4-mediated and KCa2.3-mediated EDHF responses. Conclusion: These results suggest an important role for the TRPV4-KCa2.3 signaling undergirding the beneficial effect of exercise to ameliorate age-related arterial dysfunction.


Asunto(s)
Factores Biológicos/metabolismo , Células Endoteliales/metabolismo , Endotelio Vascular/metabolismo , Canales de Potasio Calcio-Activados/metabolismo , Canales Catiónicos TRPV/metabolismo , Animales , Enfermedades Cardiovasculares/fisiopatología , Endotelio Vascular/fisiopatología , Masculino , Ratas , Ratas Sprague-Dawley , Vasodilatación/fisiología
18.
Int. j. cardiovasc. sci. (Impr.) ; 32(5): 517-526, Sept-Oct. 2019. tab
Artículo en Inglés | LILACS | ID: biblio-1040109

RESUMEN

Patients with mental disorders are more susceptible to cardiovascular diseases and metabolic disorders compared to the general population. Objective: To evaluate cardiovascular risk and metabolic syndrome in individuals with mental disorders. Materials and methods: A cross-sectional study, conducted at the Psychosocial Care Centers. Socioeconomic, clinical, biochemical and anthropometric data were collected using a standard form. Cardiovascular risk was assessed by the Framingham risk score. Metabolic syndrome (MS) was determined by the World Health- Organization (WHO), the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) criteria. Data were analyzed by descriptive statistics, and associations were evaluated by the chi-square test and Fisher's exact test, as well as Odds Ratio. The significance level adopted for all statistical tests was 5%. Results: The chance of individuals diagnosed with MS be at intermediate-to-high cardiovascular risk was greater (12.22, 8.01 and 6.23 times higher according to WHO, NCEP and IDF criteria, respectively) than those without MS. Conclusion: A high percentage of patients with mental disorders were at intermediate / high cardiovascular risk, and this was significantly associated with MS


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Enfermedades Cardiovasculares/fisiopatología , Síndrome Metabólico , Trastornos Mentales , Organización Mundial de la Salud , Índice de Masa Corporal , Salud Mental , Prevalencia , Estudios Transversales/métodos , Análisis Estadístico , Factores de Riesgo , Diabetes Mellitus , Circunferencia Abdominal , Sistemas de Apoyo Psicosocial , HDL-Colesterol
20.
Clín. investig. arterioscler. (Ed. impr.) ; 31(5): 233-240, sept.-oct. 2019. graf, tab
Artículo en Español | IBECS | ID: ibc-184167

RESUMEN

El sedentarismo y la inactividad física son altamente prevalentes globalmente y están asociados a un amplio rango de enfermedades crónicas y muerte prematura. El interés en la conducta sedentaria está justificado por la creciente evidencia que apunta hacia una relación entre esta conducta y el incremento en la prevalencia de obesidad, diabetes y enfermedad cardiovascular. A través de la historia es bien conocido que ser inactivo no es saludable, pero hoy día casi un tercio de la población del mundo es inactiva, lo que representa un serio problema de salud pública


Sedentarism and physical inactivity is highly prevalent globally, and are associated with a wide range of chronic diseases and premature deaths. The interest in sedentary behaviour is justified by a growing body of evidence that points to a relationship between this lifestyle and the increase in the prevalence of obesity, diabetes and cardiovascular disease. It has been known throughout history that being inactive is unhealthy, but nowadays almost one-third of the world's population is inactive, thus representing a major public health problem


Asunto(s)
Humanos , Conducta Sedentaria , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Factores de Riesgo , Salud Pública , Enfermedades Cardiovasculares/fisiopatología , Impactos en la Salud
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA