Current vascular pharmacology最新文献

Introduction: This study aimed to investigate the factors influencing medication adherence in community-dwelling Chinese older adults with hypertension.

Design: Empirical research-quantitative; Cross-sectional study.

Methods: A cross-sectional survey was conducted from September to December 2021, in which participants completed a self-administered questionnaire with detailed their demographic information. The Morisky Medication Adherence Scale-8, the Pittsburgh Sleep Quality Index, and the 10-item Kessler Psychological Distress Scale were used to assess medication adherence, sleep quality, and psychological well-being, respectively. Multivariate logistic regression analysis was performed with medication adherence as the dependent variable to identify factors influencing adherence.

Results: The study included 867 patients with hypertension, comprising 566 women and 301 men with a mean age of 70.89 ± 7.50 years. Results indicated that 53.9% of participants exhibited high medication adherence, while 24.5% and 21.7% demonstrated medium and low adherence levels, respectively. Multiple logistic regression analysis revealed that individuals in the 50-59 age group had lower medication adherence compared to those aged 80 years and older (odds ratio [OR]: 0.468, 95% confidence interval [CI]: 0.245,0.894). In addition, participants with a primary school education or less (OR: 0.152, 95% CI: 0.095,0.245) and those living alone (OR: 0.362, 95% CI: 0.228, 0.575) exhibited poorer medication adherence. Conversely, living in an urban area was associated with better adherence (OR: 2.131, 95% CI: 1.402, 3.239, p < 0.001).

Conclusion: Our study showed that participants' medication adherence was below the desired level. It was observed that older adults, those with a junior high school education or higher, and those living in urban areas with their children had better medication adherence. These identified predictors may help to identify individuals at high risk of poor adherence, enabling the implementation of effective interventions to reduce the global burden of hypertension.

Introduction/objective: Emotional, mental, or psychological distress, defined as increased symptoms of depression, anxiety, and/or stress, is common in patients with chronic diseases, such as cardiovascular (CV) disease (CVD).

Methods: Literature was reviewed regarding data from studies and meta-analyses examining the impact of emotional stress on the occurrence and outcome of several CVDs (coronary disease, heart failure, hypertension, arrhythmias, stroke). These influences' pathophysiology and clinical spectrum are detailed, tabulated, and pictorially illustrated.

Results: This type of stress is a newly recognized risk and prognosticator for CVD including coronary artery disease, heart failure, hypertension, cardiac arrhythmias, and stroke, independently of conventional risk factors. It can impact CV outcomes, and also affect health care utilization, with more patient visits to health care facilities. The biological systems activated by mental stress comprise the sympathetic nervous system (SNS), the renin-angiotensin system (RAS), and the hypothalamic- pituitary-adrenal (HPA) axis, while several other biological processes are disrupted, such as endothelial function, inflammatory responses, oxidative stress, mitochondrial function and the function of the amygdala which is the central nervous system processing center of emotions and emotional reactions.

Conclusion: Emotional stress that aggravates symptoms of depression, anxiety, and/or perceived mental stress is common in patients with chronic diseases, such as CVD. It is a newly recognized risk and prognosticator for several CVDs. It can influence CV outcomes, and also affect health care utilization. The biological systems activated by mental stress comprise the SNS, the RAS, and the HPA axis, while several other biological processes are disrupted.

Purpose: The objective of this study was to explore the relationship among serum levels of the growth-stimulating expressed gene 2 protein (ST₂), Galectin-3 (GAL-3), N-terminal pro-Btype natriuretic peptide (NT-proBNP) in elderly hypertensive patients and heart failure with preserved ejection fraction (HFpEF).

Materials and methods: Eighty-five elderly hypertensive patients with HFpEF were registered as the HFpEF group, and 46 hypertensive patients without HF were registered as the Non-HF group. The levels of serum sST2 (soluble ST2), Galectin-3, and NT-proBNP were measured, and related indexes of heart function were performed with echocardiography in two groups, respectively.The obtained variables were applied to statistical software for analysis.

Results: Age, BMI, SBP, DBP, TC, LDL-C, HCY, sST2, Galectin-3, NT- proBNP, LVEDD, IVSD, LVEF, and E/A were obviously different between the two groups (p < 0.05). The levels of sST₂, Galectin- 3 and NT- proBNP in the HFpEF group were higher than in the Non-HF group (P < 0.05). ANOVA results indicated that sST2, Galectin-3, and NT- proBNP levels increased gradually with the increasing NYHA grades (P<0.05). BMI, SBP, DBP, TC, LDL-C, FBG, UA, HCY, LVEDD, IVSD, LVEF, and E/A were significant differences in patients with different NYHA classes (P < 0.05). Spearman indicated that sST2, Galectin-3, and NT-proBNP were positively correlated with BMI, SDP, DBP, LDL-C, FBG, and HCY (P < 0.05). Logistic analysis indicated that BMI, SBP, DBP, FBG, HCY, sST2, Galectin-3, NT-proBNP, LVEDD, LVEF, and E/A were risk factors for hypertension with HFpEF (P < 0.05). ROC indicated that the AUC of the diagnostic performance of sST₂, Galectin-3, and NT-proBNP were all above 0.7, which may have some forecasting value for elderly hypertensive patients with HFpEF.

Conclusion: The levels of sST₂, Galectin-3, and NT-proBNP were closely related to cardiac function grades. sST2, Galectin-3, and NT-proBNP have similar diagnostic performance and predictive value for elderly hypertensive patients with HFpEF. sST2 was more sensitive than NT-proBNP. It is recommended that measurements of sST2, Galectin-3 and NT-proBNP levels in elderly hypertensive patients may be useful in classifying early HFpEF.

With the aging population on the rise, the higher prevalence of atrial tachyarrhythmia is emerging as a significant healthcare concern. Atrial fibrillation (AF) stands out as the most common atrial tachyarrhythmia, potentially leading to adverse outcomes, such as stroke, heart failure (HF), or conduction dysfunction. Furthermore, AF may serve as a manifestation of underlying atrial cardiomyopathy, which forms the structural and electrical substrate for arrhythmias. Atrial cardiomyopathy is characterized by structural and electrical remodeling of the atria, resulting in impaired mechanical function and the generation of arrhythmias. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have recently emerged as a novel medical treatment for HF. Their use has been associated with a reduced incidence of new-onset AF, potentially attributing to the improvement of atrial cardiomyopathy. This effect is achieved through the regulation of glucose utilization and energy consumption within the myocardium. It is worth noting that the sirtuin signaling pathway plays a crucial role in regulating energy consumption, especially in the presence of increased oxidative stress and fibrosis. This pathway also exerts a significant influence on various cardiovascular diseases. This review aims to provide a comprehensive summary of the involvement of the sirtuin signaling pathway in cardiovascular diseases, with a specific focus on atrial cardiomyopathy and AF and the potential molecular mechanisms of SGLT2is in the sirtuin signaling pathway and atrial cardiomyopathy.

Resveratrol [RES] is a polyphenolic stilbene with therapeutic potential owing to its antioxidant, anti-inflammatory, neuroprotective, and cardioprotective properties. However, the very poor oral bioavailability, fast metabolism, and extremely low stability under physiological conditions pose a severe detriment to the clinical use of RES. This newly developed field of nanotechnology has led to the formulation of RES into nanoformulations with the goal of overcoming metabolicpharmacokinetic limitations and enhancing the targeted transport of RES to the central nervous system [CNS]. Among the various routes of administration, the combination of nose-to-brain [N2B] delivery via the intranasal [IN] route has recently garnered attention as a straightforward, noninvasive route for transport to the blood-brain barrier [BBB] for greater effects and less harmful systemic side effects by transporting nano-encapsulated RES into the neural tissues. This review critically summarizes the mechanisms and benefits of the N2B route for the delivery of RES nanoformulations, collating in vivo data demonstrating increased CNS bioavailability and stability and, consequently, improved therapeutic efficacy in animal models of neurodegenerative diseases. Compared with the more 'traditional' routes of administration, IN administration of RES nanoformulations is less toxic, cost-effective, and efficient in crossing the BBB. Therefore, this route represents a promising approach to the management of CNS disorders. Further optimization of nanoformulation design and clinical protocols is required to translate these promising findings into therapeutic strategies aimed at neuroprotection and disease modification in human CNS pathologies.

Neutrophil elastase (NE), a major protease in neutrophils, is important in promoting inflammation and multiple pathological processes. While NE is released abundantly in ischemiareperfusion (I/R) injury, the intricate relationship between NE and I/R injury remains unclear. We examine several aspects of how NE is involved in I/R injury. We also discuss the possibility of NE inhibitors used for abbreviating various types of I/R injury, such as myocardial infarction, based on preclinical research and clinical trials. Furthermore, we highlight the key question, the balance of NE and NE inhibitors, and propose new research directions. This review is useful for understanding the intrinsic interplay between NE and I/R injury-related diseases and expects to facilitate the development of effective NE inhibitors applied for I/R injury.

Background: Diabetic nephropathy, a major contributor to chronic kidney disease, is closely associated with inflammatory responses.

Objectives: This study aimed to evaluate the effectiveness of combination therapy with dapagliflozin and telmisartan in treating diabetic nephropathy and its effect on patient's albuminuria levels.

Materials and methods: We conducted a 12-week prospective observational study to assess diabetic nephropathy. Patients with diabetic nephropathy were treated with either dapagliflozin and telmisartan (n=92) or telmisartan alone (n=92). Measurements of waist-to-hip ratio, fasting blood glucose, hemoglobin A1c (HbA1c), blood pressure, urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), uric acid, blood urea nitrogen, lipid profile, and inflammatory biomarkers, including C-C motif chemokine ligand 21 messenger RNA (CCL21 mRNA) and monocyte chemoattractant protein-1 (MCP-1), were obtained at baseline and following 12-weeks of treatment.

Results: Dapagliflozin and telmisartan combination therapy demonstrated a significant decrease in UACR compared with baseline levels (p<0.001). After treatment, the dapagliflozin and telmisartan group had significantly lower waist-to-hip ratio, fasting blood glucose, HbA1c, uric acid, total cholesterol, and low-density lipoprotein compared with the monotherapy group (p<0.05). Additionally, inflammatory biomarkers, including CCL21 mRNA and MCP-1, were substantially lower in the combination therapy group than in the monotherapy group (p<0.05).

Conclusion: In comparison to monotherapy, combination therapy demonstrated more significant clinical effects in treating diabetic nephropathy. This combination therapy effectively controls blood glucose levels and UACR, reduces inflammatory responses, and improves kidney function recovery in diabetic nephropathy patients, thereby enhancing the overall clinical treatment outcomes for these patients.

Empagliflozin (EMPA), a sodium-glucose cotransporter 2 inhibitor (SGLT2i), represents a novel therapeutic agent for diabetes management. Over the past decade, studies have consistently demonstrated that EMPA not only effectively lowers blood glucose levels but also confers substantial cardiovascular benefits without inducing hypoglycemia. This holds for individuals with or without diabetes, highlighting EMPA's potential in mitigating the risk of adverse cardiovascular events and cardiovascular mortality. The underlying mechanisms driving these advantageous effects remain incompletely understood, with presently elucidated pathways encompassing blood pressure reduction, oxidative stress attenuation, anti-inflammatory properties, metabolic regulation, uric acid level modulation, inhibition of Na+/H+ exchangers, preservation of mitochondrial function, vascular protection, and regulation of myocardial autophagy. In this review, we considered the effects and mechanisms of EMPA in combating diabetic cardiomyopathy (DCM), underscoring its therapeutic relevance in addressing cardiovascular complications associated with diabetes.