Pub Date : 2024-11-01DOI: 10.1016/j.pcad.2024.11.001
Carl J. Lavie
{"title":"Assorted topics III 2024","authors":"Carl J. Lavie","doi":"10.1016/j.pcad.2024.11.001","DOIUrl":"10.1016/j.pcad.2024.11.001","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"87 ","pages":"Page 1"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.pcad.2024.10.001
Afshin Heidari , Mohammad Ghorbani , Sara Hassanzadeh , Elham Rahmanipour
Background
Takotsubo Cardiomyopathy (TCM) is a transient heart condition often precipitated by stress and characterized by atypical ventricular ballooning. The interplay between TCM and Adrenal Insufficiency (AI), particularly the influence of catecholamine excess and glucocorticoid deficiency on TCM's pathogenesis in individuals with AI, warrants comprehensive exploration for a better understanding of TCM pathophysiology and establishment of potential therapeutic strategies.
Methods
We conducted an extensive literature search via PubMed and Google Scholar, targeting reports on AI, heart failure, and cardiomyopathy, supplemented by forward and backward citation tracing. We analyzed 46 cases from 45 reports, assessing the clinical presentation and outcomes in the context of AI categorization.
Results
In patients with AI, a glucocorticoid deficit appears to exacerbate the myocardial vulnerability to catecholamine toxicity, precipitating TCM. Most conditions were reversible; however, three pre-1990 cases resulted in irreversible outcomes.
Conclusions
The investigation into the AI and TCM intersection highlights the pathogenic significance of catecholamines in the absence of glucocorticoids. The data consolidates the hypothesis that glucocorticoid scarcity exacerbates the cardiac susceptibility to catecholaminergic toxicity, potentially triggering TCM. The study affirms glucocorticoids' cardioprotective roles and elucidates how catecholamine surges contribute to TCM pathogenesis, suggesting strategic clinical management adjustments for AI patients to reduce TCM incidence.
背景:塔克氏心肌病(Takotsubo Cardiomyopathy,TCM)是一种一过性心脏疾病,通常由应激诱发,以非典型心室气囊扩张为特征。中药与肾上腺功能不全(AI)之间的相互作用,尤其是儿茶酚胺过多和糖皮质激素缺乏对中药在 AI 患者中发病机制的影响,值得进行全面探讨,以更好地了解中药的病理生理学并制定潜在的治疗策略:我们通过 PubMed 和 Google Scholar 进行了广泛的文献检索,主要针对有关人工智能、心力衰竭和心肌病的报道,并辅以正向和反向引文追踪。我们分析了 45 篇报道中的 46 个病例,并根据 AI 分类评估了临床表现和预后:结果:在 AI 患者中,糖皮质激素的缺乏似乎加剧了心肌对儿茶酚胺毒性的脆弱性,从而诱发了中药。大多数情况是可逆的,但有三例 1990 年以前的病例导致了不可逆转的结果:对 AI 和中药交叉的调查强调了儿茶酚胺在糖皮质激素缺失时的致病意义。这些数据巩固了糖皮质激素缺乏会加剧心脏对儿茶酚胺能毒性的易感性,从而可能引发中医的假说。该研究肯定了糖皮质激素的心脏保护作用,并阐明了儿茶酚胺激增是如何导致中医发病的,建议对人工流产患者进行战略性临床管理调整,以降低中医发病率。
{"title":"A review of the interplay between Takotsubo cardiomyopathy and adrenal insufficiency: Catecholamine surge and glucocorticoid deficiency","authors":"Afshin Heidari , Mohammad Ghorbani , Sara Hassanzadeh , Elham Rahmanipour","doi":"10.1016/j.pcad.2024.10.001","DOIUrl":"10.1016/j.pcad.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo Cardiomyopathy (TCM) is a transient heart condition often precipitated by stress and characterized by atypical ventricular ballooning. The interplay between TCM and Adrenal Insufficiency (AI), particularly the influence of catecholamine excess and glucocorticoid deficiency on TCM's pathogenesis in individuals with AI, warrants comprehensive exploration for a better understanding of TCM pathophysiology and establishment of potential therapeutic strategies.</div></div><div><h3>Methods</h3><div>We conducted an extensive literature search via PubMed and Google Scholar, targeting reports on AI, heart failure, and cardiomyopathy, supplemented by forward and backward citation tracing. We analyzed 46 cases from 45 reports, assessing the clinical presentation and outcomes in the context of AI categorization.</div></div><div><h3>Results</h3><div>In patients with AI, a glucocorticoid deficit appears to exacerbate the myocardial vulnerability to catecholamine toxicity, precipitating TCM. Most conditions were reversible; however, three pre-1990 cases resulted in irreversible outcomes.</div></div><div><h3>Conclusions</h3><div>The investigation into the AI and TCM intersection highlights the pathogenic significance of catecholamines in the absence of glucocorticoids. The data consolidates the hypothesis that glucocorticoid scarcity exacerbates the cardiac susceptibility to catecholaminergic toxicity, potentially triggering TCM. The study affirms glucocorticoids' cardioprotective roles and elucidates how catecholamine surges contribute to TCM pathogenesis, suggesting strategic clinical management adjustments for AI patients to reduce TCM incidence.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"87 ","pages":"Pages 18-25"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.pcad.2024.10.005
Stefan Seman , Milorad Tesic , Marija Babic , Lidija Mikic , Lazar Velicki , Nduka C Okwose , Sarah J Charman , Maria Tafelmeier , Iacopo Olivotto , Nenad Filipovic , Arsen Ristic , Ross Arena , Marco Guazzi , Djordje Jakovljevic , Thomas G Allison , Dejana Popovic , on behalf of SILICOFCM study investigators
Aim
We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM).
Methods
Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO2); 2) VO2 at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO2) production slope; 5) VE/VCO2 at AT (VE/VCO2_AT); 6) VE/VCO2 nadir; 7) VE/VCO2 intercept; and 8) partial end-tidal pressure of carbon-dioxide (PETCO2) change during CPET.
Results
Of 115 screened patients, 61 (52 ± 14 years, 43 % women) were included. Within subject therapy effects were detected only by the VE/VCO2 intercept and PETCO2 change, whereas the differences between medical regimens were detected by differences in VE/VCO2 nadir and VE/VCO2_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO2 intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; p = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO2 nadir.
Conclusion
Ventilatory efficiency parameters outperform peak VO2 in gauging therapy effects in patients with HCM.
{"title":"The ventilatory efficiency parameters outperform peak oxygen consumption in monitoring the therapy effects in patients with hypertrophic cardiomyopathy","authors":"Stefan Seman , Milorad Tesic , Marija Babic , Lidija Mikic , Lazar Velicki , Nduka C Okwose , Sarah J Charman , Maria Tafelmeier , Iacopo Olivotto , Nenad Filipovic , Arsen Ristic , Ross Arena , Marco Guazzi , Djordje Jakovljevic , Thomas G Allison , Dejana Popovic , on behalf of SILICOFCM study investigators","doi":"10.1016/j.pcad.2024.10.005","DOIUrl":"10.1016/j.pcad.2024.10.005","url":null,"abstract":"<div><h3>Aim</h3><div>We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM).</div></div><div><h3>Methods</h3><div>Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO<sub>2</sub>); 2) VO<sub>2</sub> at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO<sub>2</sub>) production slope; 5) VE/VCO<sub>2</sub> at AT (VE/VCO<sub>2</sub>_AT); 6) VE/VCO<sub>2</sub> nadir; 7) VE/VCO<sub>2</sub> intercept; and 8) partial end-tidal pressure of carbon-dioxide (P<sub>ET</sub>CO<sub>2</sub>) change during CPET.</div></div><div><h3>Results</h3><div>Of 115 screened patients, 61 (52 ± 14 years, 43 % women) were included. Within subject therapy effects were detected only by the VE/VCO<sub>2</sub> intercept and P<sub>ET</sub>CO<sub>2</sub> change, whereas the differences between medical regimens were detected by differences in VE/VCO<sub>2</sub> nadir and VE/VCO<sub>2</sub>_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO<sub>2</sub> intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; <em>p</em> = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO<sub>2</sub> nadir.</div></div><div><h3>Conclusion</h3><div>Ventilatory efficiency parameters outperform peak VO<sub>2</sub> in gauging therapy effects in patients with HCM.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"87 ","pages":"Pages 90-96"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/S0033-0620(24)00157-9
{"title":"List of recent issues","authors":"","doi":"10.1016/S0033-0620(24)00157-9","DOIUrl":"10.1016/S0033-0620(24)00157-9","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"87 ","pages":"Page A3"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.pcad.2024.10.008
Xiang Jun Wang , Trudy Voortman , Tosca O.E. de Crom , Martijn Tilly , Maryam Kavousi , M. Kamran Ikram , Marinka Steur
Background
Consumption of more plant-based foods is gaining popularity, but the role of healthy versus unhealthy plant-based diets in cardiovascular disease (CVD) risk remains inconclusive.
Objectives
We investigated associations of plant-based diet indices (PDIs) with incident CVDs in a prospective cohort study and conducted an updated meta-analysis.
Methods
We included 3507 men and 5345 women of the population-based Rotterdam Study. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for CVD, coronary heart disease (CHD) and stroke per SD increment of an overall PDI, healthy PDI (hPDI) and unhealthy PDI (uPDI), among men and women separately. We combined our findings with previously published effect estimates in an updated meta-analysis.
Results
We documented 2015 CVD cases (1231 CHD and 952 stroke) during 107,290 person-years follow-up. Among men, the PDI and hPDI were associated with a 7 % (HR 0.93, 95 % CI 0.87–0.99) and 8 % (HR 0.92, 95 % CI 0.86–0.98) lower CVD risk. Among women, there was evidence suggesting a U-shaped association of the PDI with stroke (pnon-linearity < 0.01). In meta-analyses including up to 43,067 incident CVD cases among 359,740 participants from nine studies, the PDI and hPDI, were associated with a lower CVD riskand the uPDI with a higher CVD risk (pooled HRs [95 % CI], per SD, PDI: 0.94 [0.91–0.97], I2 = 50.4 %; hPDI: 0.94 [0.91–0.98], I2 = 74.7 %; uPDI: 1.03 [1.01–1.06], I2 = 49.0 %).
Conclusions
Our findings support recommendations to consume relatively more healthy plant-based foods for CVD prevention. Potential differences by sex and non-linear associations warrant further investigation.
{"title":"Healthy and unhealthy plant-based diets and the risk of cardiovascular diseases: The Rotterdam study and updated meta-analysis","authors":"Xiang Jun Wang , Trudy Voortman , Tosca O.E. de Crom , Martijn Tilly , Maryam Kavousi , M. Kamran Ikram , Marinka Steur","doi":"10.1016/j.pcad.2024.10.008","DOIUrl":"10.1016/j.pcad.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Consumption of more plant-based foods is gaining popularity, but the role of healthy versus unhealthy plant-based diets in cardiovascular disease (CVD) risk remains inconclusive.</div></div><div><h3>Objectives</h3><div>We investigated associations of plant-based diet indices (PDIs) with incident CVDs in a prospective cohort study and conducted an updated meta-analysis.</div></div><div><h3>Methods</h3><div>We included 3507 men and 5345 women of the population-based Rotterdam Study. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for CVD, coronary heart disease (CHD) and stroke per SD increment of an overall PDI, healthy PDI (hPDI) and unhealthy PDI (uPDI), among men and women separately. We combined our findings with previously published effect estimates in an updated meta-analysis.</div></div><div><h3>Results</h3><div>We documented 2015 CVD cases (1231 CHD and 952 stroke) during 107,290 person-years follow-up. Among men, the PDI and hPDI were associated with a 7 % (HR 0.93, 95 % CI 0.87–0.99) and 8 % (HR 0.92, 95 % CI 0.86–0.98) lower CVD risk. Among women, there was evidence suggesting a U-shaped association of the PDI with stroke (<em>p</em><sub>non-linearity</sub> < 0.01). In meta-analyses including up to 43,067 incident CVD cases among 359,740 participants from nine studies, the PDI and hPDI, were associated with a lower CVD riskand the uPDI with a higher CVD risk (pooled HRs [95 % CI], per SD, PDI: 0.94 [0.91–0.97], I<sup>2</sup> = 50.4 %; hPDI: 0.94 [0.91–0.98], I<sup>2</sup> = 74.7 %; uPDI: 1.03 [1.01–1.06], I<sup>2</sup> = 49.0 %).</div></div><div><h3>Conclusions</h3><div>Our findings support recommendations to consume relatively more healthy plant-based foods for CVD prevention. Potential differences by sex and non-linear associations warrant further investigation.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"87 ","pages":"Pages 8-15"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.pcad.2024.10.011
Oluwapeyibomi I. Runsewe , Sunil K. Srivastava , Sumit Sharma , Pulkit Chaudhury , W.H. Wilson Tang
Endothelial dysfunction and microvascular remodeling underly the development and progression of a host of cardiovascular disease (CVD). However, current methods to assess coronary epicardial microvascular function are invasive, time-intensive, and costly. Optical coherence tomography angiography (OCTA) is an established technology within ophthalmology that provides a quick, noninvasive assessment of vascular structures within the retina. As a growing body of evidence reveals strong associations between the retinal changes on OCTA and the development and progression of CVD, OCTA may indeed be a surrogate test for end-organ dysfunction. OCTA has potential to enhance diagnostic performance, refine cardiovascular risk assessment, strengthen prognostication, and ultimately, improve patient care. We explore the current literature on OCTA in cardiovascular diseases to summarize the clinical utility of retinal OCTA imaging and discuss next-generation cardiovascular applications.
{"title":"Optical coherence tomography angiography in cardiovascular disease","authors":"Oluwapeyibomi I. Runsewe , Sunil K. Srivastava , Sumit Sharma , Pulkit Chaudhury , W.H. Wilson Tang","doi":"10.1016/j.pcad.2024.10.011","DOIUrl":"10.1016/j.pcad.2024.10.011","url":null,"abstract":"<div><div>Endothelial dysfunction and microvascular remodeling underly the development and progression of a host of cardiovascular disease (CVD). However, current methods to assess coronary epicardial microvascular function are invasive, time-intensive, and costly. Optical coherence tomography angiography (OCTA) is an established technology within ophthalmology that provides a quick, noninvasive assessment of vascular structures within the retina. As a growing body of evidence reveals strong associations between the retinal changes on OCTA and the development and progression of CVD, OCTA may indeed be a surrogate test for end-organ dysfunction. OCTA has potential to enhance diagnostic performance, refine cardiovascular risk assessment, strengthen prognostication, and ultimately, improve patient care. We explore the current literature on OCTA in cardiovascular diseases to summarize the clinical utility of retinal OCTA imaging and discuss next-generation cardiovascular applications.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"87 ","pages":"Pages 60-72"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.pcad.2024.08.005
Gen-Min Lin , Kun-Zhe Tsai , Yun-Chen Chang , Pang-Yen Liu , Xuemei Sui , Carl J. Lavie , Po-Shun Hsu
Background
The use of substances, e.g., tobacco and betel nut, are prevalent among military personnel in Taiwan, whereas some specific substances such as alcohol use are forbidden in military base. There were inconsistent findings for the incidence of hypertension with habitual substances use in diverse populations, while no studies were carried out in the military.
Methods
A total of 2419 Taiwanese military personnel, aged 18–39 years, who were not taking any antihypertensive agents and did not have a baseline systolic blood pressure (SBP) ≥130 mmHg and/or diastolic blood pressure (DBP) ≥80 mmHg were followed for incidence of hypertension from baseline (2014) through the end of 2020. Alcohol, tobacco and betel nut use status (active vs. former/never) were self-reported by each participant at baseline. New-onset hypertension of each participant was defined by an average of two resting BP measurements in the annual health examinations (2015–2020). Multivariable Cox regression analysis with adjustments for baseline BP and other potential covariates were performed to determine the risk of incident hypertension with each substance use. Five-year absolute changes in BP level with specific substance use were compared using analysis of covariance (ANCOVA).
Results
There were 867 active smokers (35.8 %), 237 active betel nut chewers (9.8 %) and 961 active alcohol consumers (39.7 %) at baseline. During a median follow-up of 5.8 years, 911 new-onset hypertension events (37.7 %) were observed. While compared to those without any substances use, merely active holiday alcohol users had a significantly lower risk of incident hypertension [hazard ratio (HR) and 95 % confidence interval: 0.72 (0.58–0.89)]. The 5-year diastolic BP increase (mmHg) was borderline significantly lower in active alcohol users on holidays as compared to former/never alcohol users (4.02 (standard deviation =9.01) and 4.76 (9.42), p = 0.07). The risk of incident hypertension was not significant in active smokers and active betel nut users, while the 5-year BP increase level was significantly greater in active smokers than former/never smokers (5.60 (9.96) vs. 4.42 (9.22), p = 0.03).
Conclusion
Our findings suggest that military young personnel consuming alcohol only allowed on holidays had a lower incidence of new-onset hypertension. On the contrary, the 5-year BP change may increase greater with habitual smoking, though the risk of new-onset hypertension was not affected.
{"title":"Substances use and risk of hypertension before midlife in military young adults: CHIEF cohort study, 2014–2020","authors":"Gen-Min Lin , Kun-Zhe Tsai , Yun-Chen Chang , Pang-Yen Liu , Xuemei Sui , Carl J. Lavie , Po-Shun Hsu","doi":"10.1016/j.pcad.2024.08.005","DOIUrl":"10.1016/j.pcad.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>The use of substances, e.g., tobacco and betel nut, are prevalent among military personnel in Taiwan, whereas some specific substances such as alcohol use are forbidden in military base. There were inconsistent findings for the incidence of hypertension with habitual substances use in diverse populations, while no studies were carried out in the military.</div></div><div><h3>Methods</h3><div>A total of 2419 Taiwanese military personnel, aged 18–39 years, who were not taking any antihypertensive agents and did not have a baseline systolic blood pressure (SBP) ≥130 mmHg and/or diastolic blood pressure (DBP) ≥80 mmHg were followed for incidence of hypertension from baseline (2014) through the end of 2020. Alcohol, tobacco and betel nut use status (active vs. former/never) were self-reported by each participant at baseline. New-onset hypertension of each participant was defined by an average of two resting BP measurements in the annual health examinations (2015–2020). Multivariable Cox regression analysis with adjustments for baseline BP and other potential covariates were performed to determine the risk of incident hypertension with each substance use. Five-year absolute changes in BP level with specific substance use were compared using analysis of covariance (ANCOVA).</div></div><div><h3>Results</h3><div>There were 867 active smokers (35.8 %), 237 active betel nut chewers (9.8 %) and 961 active alcohol consumers (39.7 %) at baseline. During a median follow-up of 5.8 years, 911 new-onset hypertension events (37.7 %) were observed. While compared to those without any substances use, merely active holiday alcohol users had a significantly lower risk of incident hypertension [hazard ratio (HR) and 95 % confidence interval: 0.72 (0.58–0.89)]. The 5-year diastolic BP increase (mmHg) was borderline significantly lower in active alcohol users on holidays as compared to former/never alcohol users (4.02 (standard deviation =9.01) and 4.76 (9.42), <em>p</em> = 0.07). The risk of incident hypertension was not significant in active smokers and active betel nut users, while the 5-year BP increase level was significantly greater in active smokers than former/never smokers (5.60 (9.96) vs. 4.42 (9.22), <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that military young personnel consuming alcohol only allowed on holidays had a lower incidence of new-onset hypertension. On the contrary, the 5-year BP change may increase greater with habitual smoking, though the risk of new-onset hypertension was not affected.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"86 ","pages":"Pages 48-53"},"PeriodicalIF":5.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.pcad.2024.09.001
Saivaroon Gajagowni , Steven Hopkins , Yusuf Qadeer , Salim S. Virani , Job A.J. Verdonschot , Catherine C. Coombs , Christopher I. Amos , Kevin T. Nead , Siddhartha Jaiswal , Chayakrit Krittanawong
Clonal hematopoiesis of indeterminate potential (CHIP) is a well-studied phenomenon in hematologic malignancies. With advancements in gene sampling and analysis and the use of large cohort studies, CHIP has recently been linked to cardiovascular disease (CVD). The relationship between CHIP and CVD appears to be bidirectional, with traditional risk factors for cardiovascular disease increasing the mutation burden in CHIP, and CHIP itself effecting the incidence or prognosis of a variety of CVD. The purpose of this review is to understand the epidemiology, risk factors, and pathogenesis of CHIP in the context of various CVD conditions.
{"title":"Clonal hematopoiesis of indeterminate potential and cardiovascular disease: Pathogenesis, clinical presentation, and future directions","authors":"Saivaroon Gajagowni , Steven Hopkins , Yusuf Qadeer , Salim S. Virani , Job A.J. Verdonschot , Catherine C. Coombs , Christopher I. Amos , Kevin T. Nead , Siddhartha Jaiswal , Chayakrit Krittanawong","doi":"10.1016/j.pcad.2024.09.001","DOIUrl":"10.1016/j.pcad.2024.09.001","url":null,"abstract":"<div><div>Clonal hematopoiesis of indeterminate potential (CHIP) is a well-studied phenomenon in hematologic malignancies. With advancements in gene sampling and analysis and the use of large cohort studies, CHIP has recently been linked to cardiovascular disease (CVD). The relationship between CHIP and CVD appears to be bidirectional, with traditional risk factors for cardiovascular disease increasing the mutation burden in CHIP, and CHIP itself effecting the incidence or prognosis of a variety of CVD. The purpose of this review is to understand the epidemiology, risk factors, and pathogenesis of CHIP in the context of various CVD conditions.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"86 ","pages":"Pages 79-85"},"PeriodicalIF":5.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}