Knowledge and attitude toward postoperative antithrombotic management and prevention in patients with coronary revascularization: a cross-sectional study.

Background: This study aimed to explore the knowledge and attitude (KA) toward postoperative antithrombotic management and prevention among coronary artery disease (CAD) patients who underwent coronary revascularization. Methods: This cross-sectional study enrolled CAD outpatients and inpatients between May and December 2023 at Kailuan Medical Group at Tangshan. Basic demographic characteristics and KA scores were collected through a self-made questionnaire. Results: This study included 523 valid questionnaires. The mean knowledge and attitude scores were 13.20 ± 6.20 (range: 0-26) and 43.68 ± 6.01 (range: 21-50), respectively, indicating poor knowledge and favorable attitude. Multivariable logistic regression analysis showed that junior high school education (OR = 2.160, P = 0.035), high school or technical school education (OR = 2.356, P = 0.039), and monthly average income >5,000 RMB (OR = 3.407, P = 0.002) were independently associated with knowledge. Knowledge (OR = 1.095, P = 0.002), BMI ≥ 24.0 kg/m2 (OR = 0.372, P = 0.011), junior high school (OR = 3.699, P = 0.002), high school or technical school (OR = 2.903, P = 0.028), high associate degree or above education (OR = 6.068, P = 0.014), monthly average income 3,000-5,000 RMB (OR = 0.296, P = 0.005), monthly average income > 5,000 RMB (OR = 0.225, P = 0.021), with hypertension (OR = 0.333, P = 0.003), blood tests every 2-3 weeks (OR = 10.811, P = 0.011), blood tests every month (OR = 4.221, P = 0.024), and blood tests every 2-3 months (OR = 3.342, P = 0.033) were independently associated with attitude. Conclusion: CAD patients who underwent coronary revascularization had poor knowledge but favorable attitudes toward postoperative antithrombotic management and prevention. The study underscores the need for targeted education, especially for individuals with lower education and income levels, ultimately improving patient compliance and cardiovascular outcomes.

Cardiovascular Health Index Scores and Pregnancy-Induced Hypertension: An Association Study.

Objective: This cohort study investigated the association between cardiovascular health index scores and pregnancy-induced hypertension (PIH). Methods: A total of 1466 first-time pregnant women who delivered a single child between 2006 and 2016 were included in the study. All participants underwent a physical examination before delivery, and seven cardiovascular health indexes were collected and scored. Three groups were created based on the tri-sectional quantiles of the total score to observe whether PIH occurred among the groups. A dichotomous logistic regression analysis was carried out to investigate the relationship between cardiovascular health index scores and the occurrence of PIH. Results: During the observation of 1150 subjects, 103 cases of PIH were identified, resulting in an incidence rate of 8.96%. The study found that the incidence of PIH in the three groups was 17.5% in the first group, 6.7% in the second, and 5.8% in the third group. These rates showed a sequential decrease with statistically significant differences (P < .001). The multifactorial regression analysis revealed that after adjusting for various factors, there was a significant inverse relationship between cardiovascular health index scores and the risk of PIH. Specifically, for every one-point increase in the seven cardiovascular health index scores, the risk of PIH decreased by 29% (OR = 0.71, 95% CI 0.59-0.86). Conclusions: The study found an inverse correlation between cardiovascular health index scores and PIH, with higher scores associated with lower incidences of PIH. Each cardiovascular health indicator helps to lower the risk of PIH, and optimum cardiovascular health behaviors and variables are protective factors against PIH.

Influence of Gestational Hypertension on Cardiovascular Health Behaviors and Factors.

Objective: A survey was conducted to analyze the epidemiological differences in ideal cardiovascular health (CVH) behaviors and factors after delivery in females with and without gestational hypertension (GH) and evaluate the influence of GH on cardiovascular health behaviors and factors. Methods: The present study adopted a cross-sectional design. A total of 4620 female workers who gave birth between 1976 and 2012 and received the annual health examination (2012 to 2013) at hospitals belonging to the Kailuan Medical Group were recruited. These subjects were divided into the GH group and non-GH (NGH) group, depending on whether they were combined with GH or not at delivery. The epidemiological differences in CVH behaviors and factors were compared between the two groups. Result: In both groups, the percentage of subjects achieving ideal smoking status was the highest, while the percentage of subjects achieving an ideal level of physical activity was the lowest among all behaviors and factors. Compared with the NGH group, the percentages of subjects achieving each of the seven ideal CVH metrics decreased in the GH group. The percentages of subjects achieving ideal body mass index (BMI), blood pressure, blood glucose level, and cholesterol level were significantly lower in the GH group than in the NGH group (P < 0.05). The percentage of subjects with an ideal level of physical activity was higher in the NGH group than in the GH group. After stratification by age, the percentages of patients achieving ideal BMI, blood pressure, and blood glucose decreased with age regardless of the history of GH (P < 0.05). In the younger age group, the percentage of subjects with GH achieving ideal body mass index was significantly lower than that of those without GH. Conclusion: Compared with females without GH, those with GH had higher BMI, blood pressure, blood glucose level, and cholesterol level among the seven CVH metrics surveyed.

Losartan Attenuates Myocardial Endothelial-To-Mesenchymal Transition in Spontaneous Hypertensive Rats via Inhibiting TGF-ß/Smad Signaling.

BACKGROUND: Losartan plays an important role in the inhibition of myocardial fibrosis. But the underlying mechanism is not entirely clear. Emerging evidences have indicated that endothelial-to-mesenchymal transition (EndMT) plays a crucial role in cardiac fibrosis. Here the present study aims to first investigated the effect of Losartan on EndMT in cardiac fibrosis of spontaneous hypertensive rats (SHRs). METHODS: Male SHRs were randomly divided into three groups and fed for 12 weeks, namely the SHR group (Group S), the Losartan-treated group (Group L) and the Prazosin-treated group (Group P). Wistar-Kyoto rats served as controls (Group W). The histological changes were evaluated by Masson's trichrome. Co-expression of CD31 and fibroblast-specific protein 1 (FSP1) were used as the markers of EndMT through immunofluorescence. The expressions of FSP1, CD31, TGF-ß, Smad were detected by Western blot analysis. RESULTS: It was identified that elevated blood pressure induced a significant increase in myocardial fibrosis and EndMT in SHRs, which was reversed by Losartan and Prazosin treatment. Furthermore, the activity of TGF-ß/Smad signaling was detected in the four groups. TGF-ß/Smad signaling was activated in SHRs and suppressed by Losartan or Prazosin treatment. Losartan exhibited more efficiently than Prazosin in inhibiting TGF-ß/Smad signaling activation, EndMT and myocardial fibrosis. CONCLUSION: These results showed that EndMT played an important role in promoting hypertensive cardiac fibrosis, and that losartan could suppress cardiac fibrosis through the inhibition of EndMT via classical TGF-ß/Smad pathway.