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Background: Cardiovascular diseases (CVD) remain a major global health burden. Obesity and type 2 diabetes mellitus (T2DM) are key modifiable risk factors for coronary heart disease (CHD). The emergence of big data has revolutionized cardiovascular research by enabling deeper risk stratification and detection of complex interactions among clinical, lifestyle, and molecular variables.

Objective: This article reviews how big data has advanced our understanding of the links between obesity, T2DM, and CHD. It highlights key findings from large cohort studies and international consortia as well as methodological innovations transforming cardiovascular epidemiology.

Results: The data reveal that obesity and diabetes show significant regional differences in prevalence and incidence and are associated with other risk factor such as hypertension. Large-scale cohorts and consortia have confirmed that diabetes substantially increases CVD and mortality risk two- to fourfold and is linked to an up to 75% higher mortality rate, with earlier onset and poor glycemic control worsening outcomes. Novel approaches, including polygenic risk scores, machine learning, and real-world data integration, have improved prediction and causal inference. The interplay between obesity and diabetes is a major driver of CHD burden.

Conclusion: Big data has enhanced our understanding of cardiovascular risks associated with obesity and diabetes, improved risk prediction models, and provided a foundation for precision prevention strategies. Continued investment in large cohorts, data harmonization, and digital health tools is essential in order to translate these insights into effective public health strategies and reduce the global CVD burden.

To overcome the increasing prevalence of obesity and associated secondary diseases, effective treatment strategies are required. While bariatric surgery (BS) is an established method for significant and sustainable weight reduction, drug treatment with glucagon-like peptide 1 (GLP-1), GLP‑1 receptor agonists (GLP‑1 RA) and dual glucose-dependent insulinotropic peptide (GIP)/GLP‑1 RA has gained increasing importance in recent years. This article highlights the effects of these both treatment approaches on body weight, cardiometabolic risk factors and long-term prognosis, particularly with respect to cardiovascular events and remission of type 2 diabetes. While BS shows more robust weight loss and greater improvement in metabolic parameters, GLP‑1 RA and dual GIP/GLP‑1 RA offer a conservative treatment alternative with a good safety profile. The choice of treatment should be individualized based on the patient risk profile and preferences.

Background: Atrial fibrillation (AF) is a complex arrhythmia often worsened by hypertension (HTN). Pharmacological treatments frequently underperform, and the best approach, particularly combining renal denervation (RDN) with cardiac ablation (CA), remains unclear.

Objective: We conducted an updated meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of RDN combined with CA versus CA alone in patients with AF and uncontrolled HTN.

Methods: We performed a systematic review and meta-analysis of RCTs retrieved from PubMed, Embase, and the Cochrane Library up to July 2024. Primary outcomes included AF recurrence, periprocedural complications, blood pressure changes, and estimated glomerular filtration rate (eGFR). Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were computed using a random-effects model.

Results: Eight RCTs were included, involving 689 patients (37% female). Of these, 355 underwent RDN + CA, and 334 underwent CA alone, with a mean follow-up of at least 12 months. The RDN + CA group exhibited a significant reduction in AF recurrence (RR: 0.77; 95% CI: 0.61-0.97). There were no significant differences in periprocedural complications (RR: 1.06; 95% CI: 0.60-1.89), systolic blood pressure (MD: -6.79; 95% CI: -14.71-1.14), diastolic blood pressure (MD: -2.47; 95% CI: -8.13-3.20), or eGFR (MD: 1.14; 95% CI: -11.95-14.23).

Conclusion: Our findings show that RDN combined with CA significantly reduces AF recurrence compared to CA alone, presenting a promising approach for patients with resistant HTN and AF.

Diabetes, obesity, and cardiovascular disease (CVD) represent an escalating global health challenge, contributing significantly to morbidity, mortality, and healthcare costs. Evidence from large cohort studies and clinical trials underscores the impact of diabetes and obesity as major risk factors for CVD, causing systemic inflammation, insulin resistance, and neurohormonal activation. Frequently, a sedentary lifestyle and unbalanced dietary habits are associated with these risk factors. Physical activity and exercise training interventions, a Mediterranean and plant-based diet, smoking cessation, and reduction of alcohol have shown promise in mitigating these risks. The implementation of lifestyle and pharmacotherapy have emerged as new pillars of preventive medicine. This review discusses the evidence of lifestyle interventions to reduce the burden of diabetes, obesity, and CVD. It is highlighted that only a multifaceted, sustained approach integrating lifestyle interventions and pharmacological strategies can reduce the burden of disease and improve long-term outcomes.

Obesity is a chronic, progressive, and relapsing disease that can contribute to morbidity, reduced life expectancy, and adverse health outcomes. The prevalence of obesity increased worldwide in the past 60 years, mainly because of changes in our environment and society. With the technical revolution of the last century, new modes of transportation and working conditions, automatization, and computerization, human energy demands have decreased. In parallel, the availability of energy-dense food, refined carbohydrates, and fat has markedly increased. These developments in society clash with biological factors that predispose humans to the development of obesity. At the individual level, obesity is the result of a long-term imbalance between too much energy consumed and too little energy expended. Therefore, lifestyle and behavior interventions aimed at reducing calorie intake and increasing energy expenditure target the root causes of obesity. However, both at the individual and population level, obesity prevention and treatment strategies that are based only on behavior modification are frequently not successful in the long term. The limited effectiveness of behavior interventions on weight loss are explained by complex and persistent hormonal, metabolic, and neurochemical adaptations that prevent weight loss and promote weight regain. However, behavior interventions lead to important health benefits beyond weight loss and are therefore an integral part of obesity management. This review discusses how a better understanding of the pathophysiology of obesity can influence weight loss strategies through behavioral modification. The complex factors contributing to the development of obesity require a multimodal long-term approach that is based on behavior interventions but may also include pharmacological or surgical approaches. The treatment paradigm has recently shifted from simple weight loss strategies towards treating obesity as a multisystem disease.

The diagnosis of heart failure with reduced ejection fraction (HFrEF) is based on clinical symptoms, such as peripheral edema or dyspnea and a left ventricular ejection fraction (LVEF) of 40% or less. Treatment is based particularly on the "fantastic four" of renin-angiotensin-aldosterone system (RAAS) inhibitors, preferential angiotensin receptor neprilysin inhibitor (ARNI), beta-blockers, mineralocorticoid receptor antagonists (MRA) and sodium-glucose-linked transporter 2 (SGLT2) inhibitors. These agents have a class I recommendation and show significant benefits in terms of mortality and hospitalization rates. The rapid and complete implementation of the pharmacotherapy substantially improves the prognosis. Additional options, such as ivabradine, vericiguat or digoxin, can be considered if the standard treatment is insufficient. Iron deficiency frequently occurs in HFrEF patients and is associated with increased mortality. Intravenous iron supplementation improves the exercise capacity and reduces hospitalizations.

Background: Pulmonary arterial hypertension is a severe pulmonary vascular disease, marked by high mortality and substantial treatment costs, underscoring the urgent need for the exploration of traditional Chinese medicine as a potential therapeutic strategy for pulmonary hypertension. This study aimed to investigate the underlying mechanisms of aloperine in treating PAH through network pharmacology and molecular docking approaches.

Methods: The Swiss Target Prediction database was employed to predict molecular targets of aloperine, while Cytoscape was used to construct the "active component-target" network. Disease-associated targets were identified through the GeneCards and OMIM databases and cross-referenced with drug targets to determine effective targets of aloperine for PAH treatment. Analysis of protein-protein interaction (PPI) was conducted using the STRING database. Furthermore, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were carried out via the Metascape platform.

Results: Following screening, 42 molecular targets of aloperine, 1264 disease-related targets, and 23 effective targets of aloperine in treating PAH were identified. The PPI analysis revealed that aloperine targets SLC6A2, ADRA1B, CYP2D6, CCR5, and JAK2, all of which play a therapeutic role in PAH. The GO and KEGG pathway analyses identified relevant biological functions, such as membrane raft organization, G protein-coupled amine receptor activity, and regulation of tube diameter, as well as ten pathways including neuroactive ligand-receptor interaction, the cGMP-PKG signaling pathway, calcium signaling, and vascular smooth muscle contraction. Molecular docking results confirmed the interaction between aloperine and its key targets, with a high docking affinity observed between aloperine and the core target ADRA1A.

Conclusion: Network pharmacology analysis demonstrated that aloperine exerts its therapeutic effects in PAH primarily through multi-target and multi-pathway mechanisms, providing a novel direction and foundation for PAH treatment.