1,721,027 research outputs found
People living with human immunodeficiency virus: Ccardiovascular risk screening for an early and effective risk management
No full textSocioeconomic status as determinant of individual cardiovascular risk
No full textIn this issue of Atherosclesosis, Lassale et al. aimed to assess the socioeconomic determinants of change in midlife CVH in a biracial cohort of nearly 11K people from the Atherosclerosis Risk in Communities (ARIC) study.. By recording the AHA LS7 score at baseline and 6 years later, the authors identified some vulnerable groups at higher risk of worsening CVH over time. Based on the authors’ observations, determinants of deterioration in CVH in the entire population were black race, low education, low income and unemployment. This study has crucial and relevant clinical implications outlining the features of individuals at increased risk of worsening CVH over the time, and to whom interventions of CV prevention should be primarily addressed
Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar
Full text linkThe extracts of red yeast rice (RYR) are currently the most effective cholesterol-lowering nutraceuticals. This activity is mainly due to monacolin K, a weak reversible inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, whose daily consumption causes a reduction in low-density lipoprotein (LDL)-cholesterol plasma levels up to 15% to 25% within 6 to 8 weeks. The decrease in LDL-cholesterol is accompanied by a proportional decrease in total and non–high-density lipoprotein cholesterol, plasma apolipoprotein B, and high-sensitivity C-reactive protein. Some trials suggest that RYR use is associated with improvement in endothelial function and arterial stiffness, whereas a long-term study supports its role in the prevention of cardiovascular events. Despite the statin-like mechanism of action, the risk related to 3 to 10 mg monacolin K taken per day is minimal (mild myalgia in previously severely statin-intolerant subjects). RYR could represent a therapeutic tool to support lifestyle improvement in managing mild to moderate hypercholesterolemia in low-risk patients, including those who cannot be treated with statins or other LDL-cholesterol–lowering therapies
Letter by Cicero et al Regarding Article, "long-Term Excessive Body Weight and Adult Left Ventricular Hypertrophy Are Linked Through Later-Life Body Size and Blood Pressure: The Bogalusa Heart Study"
No full textno abstract availabl
Questioning the associations of ω-3 fatty acid supplement use with cardiovascular disease risks
No full textno abstract availabl
CLINICAL EFFICACY AND SAFETY OF TREATMENT WITH BISOPROLOL AND HYDROCHLOROTHIAZIDE: A SYSTEMATIC REVIEW AND META-ANALYSIS
No full textObjective:
To assess the blood pressure (BP) lowering effect and the safety profile of treatment with bisoprolol and hydrochlorothiazide in patients affected by hypertension.
Design and method:
The study was designed in according to guidelines of the 2020 preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement.
A systematic literature search was conducted in multiple electronic databases to identify the randomized controlled clinical studies investigating the effect of combined treatment with bisoprolol and hydrochlorothiazide on BP. Effect sizes for changes in SBP and DBP were expressed as mean differences (MDs) and 95% confidence intervals (95%CIs). For safety analysis, odds ratios (OR) and 95% CI intervals were calculated using the Mantel-Haenszel method.
Results:
Data were pooled from 5 clinical studies. Meta-analysis of available data showed that treatment with Bisoprolol / Hydrochlorothiazide significantly reduced SBP [MD: -8.35 mmHg, 95%CI (-11.44, -5.25) mmHg, P <0.001, compared to control; MD: -9.88 mmHg, 95%CI (-12.62, -7.14) mmHg, P <0.001, compared to placebo] and DBP [MD: -7.62 mmHg, 95%CI (-11.20, -4.04) mmHg, P <0.001, compared to control; MD: -8.79 mmHg, 95%CI (-11.92, -5.67) mmHg, P <0.001, compared to placebo]. Moreover, BP response rate and BP control rate after treatment with Bisoprolol / Hydrochlorothiazide were significantly greater compared to control [Response rate: OR: 4.86 mmHg, 95%CI (2.52, 9.37), P <0.001; Control rate: OR: 1.67 mmHg, 95%CI (1.11, 2.51), P = 0.014]. Finally, treatment with Bisoprolol / Hydrochlorothiazide was associated with a reduced risk of any AE and peripheral edema compared to control.
Conclusions:
Our results show that treatment with Bisoprolol/Hydrochlorothiazide has favorable effects on BP and an good safety profile
The effect of highly bioavailable forms of curcumin on lipoprotein(a) plasma levels: A systematic review and meta-analysis of randomized clinical studies
No full text: Curcumin is a bioactive compound derived from the rhizome of Curcuma longa (turmeric) that has garnered increasing attention for its potential health benefits. However, its use in clinical practice is limited due to its generally poor bioavailability. This issue can be overcome using novel delivery systems that enhance curcumin's solubility, extend its residence time in plasma, improve its pharmacokinetic profile, and increase its cellular uptake. Novel curcumin formulations with improved bioavailability have been suggested to elevate plasma concentrations of lipoprotein(a) (Lp(a)), but there is no definitive evidence of a causal relationship. To address this, a systematic literature search was conducted in multiple electronic databases to identify relevant randomized placebo-controlled clinical studies published without a time limit. A meta-analysis of data suggested that dietary supplementation with highly bioavailable forms of curcumin significantly reduces Lp(a) levels [Standardized Mean Difference (SMD)= -0.96 (95 % Confidence Interval (CI): -1.82, -0.11)]. The effect size was robust in the leave-one-out sensitivity analysis and was not primarily driven by any single study. Of course, the clinical significance of this observation should be more thoroughly evaluated in longer-term trials, where the combined metabolic and anti-inflammatory effects of curcumin have vascular protective effects
Serum uric acid predicts incident metabolic syndrome in the elderly in an analysis of the Brisighella Heart Study
Full text linkSeveral epidemiological studies report a positive correlation between hyperuricemia and metabolic syndrome (MetS) in adults, which hyperuricemic subjects seem to more easily develop. We aimed to verify if serum uric acid (SUA) concentrations were positively associated with MetS prevalence and middle-term (4-year) incidence in older overall healthy subjects. We also purposed to identify which SUA cut-off values could be functional in MetS diagnosis in addition to the traditionally used parameters. For this reason, we selected from the historical cohort of the Brisighella Heart Study 923 older healthy subjects repeatedly visited during the 2008 and 2012 population surveys. In our sample, MetS was more frequent for higher SUA concentrations rather than the population’s mean in both men [OR = 2.12, 95%C.I.(1.55, 2.90)] and women [OR = 2.69,95%C.I.(1.91, 3.78)]. ROC analysis showed SUA was predictive of MetS in the whole population [AUC = 0.647, 95%C.I.(0.609, 0.686), P = 0.000001] and in both sex subgroups [men: AUC = 0.592, 95%C.I.(0.529, 654); P = 0.004; women: AUC = 0.758, 95%C.I.(0.711, 0.806), P < 0.000001], even there were sex-related differences in the best cut-off values (5.5 mg/dL for men; 4.2 mg/dL for women). Prospectively, SUA appeared predictive of middle-term (4-year) MetS incidence in the whole population (AUC = 0.604, 95%C.I.[0.518, 0.690], P = 0.029, best cut-off value = 4.7 mg/dL) and in the female group (AUC = 0,641, 95%C.I.[0.519, 0.762], P = 0.039, best cut-off value = 3.9 mg/dL) though not in the male one (P > 0.05). In conclusion, in our cohort, SUA is a frequent component of MetS, other than a middle-term predictor of newly diagnosed MetS in older women
Effect of Pycnogenol on Blood Pressure. Findings From a PRISMA Compliant Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled, Clinical Studies
No full textResults of previous clinical trials evaluating the effect of pycnogenol supplementation on blood pressure (BP) are controversial. Therefore, we aimed to assess the impact of pycnogenol on BP through a systematic review of literature and meta-analysis of available randomized, double-blind, placebo-controlled clinical studies (randomized clinical trials [RCTs]). Literature search included SCOPUS, PubMed-Medline, ISI Web of Science, and Google Scholar databases up to January 10, 2019 to identify RCTs investigating the impact of pycnogenol on BP. Two investigators independently extracted data on study characteristics, methods, and outcomes. This systematic review and meta-analysis is registered in International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42018112172. Overall, the impact of pycnogenol on BP was reported in 7 trials involving 626 participants. Meta-analysis did not suggest any significant improvement in systolic BP (weighted mean difference [WMD]: -0.028 mm Hg; 95% confidence interval [CI]: -0.182 to 0.127; P = .726; I2 = 46%), diastolic BP (WMD: -0.144 mm Hg; 95% CI: -0.299 to 0.010; P = .067; I2 = 0%), mean arterial pressure (WMD: -0.091 mm Hg; 95% CI: -0.246 to 0.063; P = .246; I2 = 0%), and pulse pressure (WMD: -0.003 mm Hg; 95% CI: -0.151 to 0.158; P = .966; I2 = 0%) following pycnogenol treatment. Results persisted in the leave-one-out sensitivity analysis. Therefore, the present meta-analysis does not suggest any significant effect of pycnogenol on BP
Optimizing Lipid Pattern by Adding a Combined Nutraceutical or Pravastatin to Fenofibrate Treatment in Hypertriglyceridemic Subjects: Single Site, Randomized, Open-Label, Post-Market Clinical Investigation
No full textIntroduction: Fenofibrate is an effective and safe treatment for hypertriglyceridemia. However, after TG reduction a residual dyslipidemia could appear and require further treatment.
Aim: To comparatively evaluate the short-term tolerability and efficacy of a combined lipid-lowering nutraceutical and pravastatin 40 mg in fenofibrate treated patients.
Method: We prospectively enrolled 40 patients well-tolerating treatment with micronized fenofibrate 145 mg/day and with residual dyslipidemia (LDL-C > 115 mg/dL and TG > 150 mg/dL). Exclusion criteria have been type 2 diabetes, Familial Hypercholesterolemia, previous cardiovascular diseases and severe chronic kidney disease. Then, we have randomly assigned the patients to treatment with pravastatin 40 mg or a combined lipid-lowering nutraceutical (Armolipid Plus®, containing monacolin 3 mg and berberine 500 mg).
Results: After 8 weeks of treatment, 80% of pravastatin treated patients (N. 16/20) and 75% of those treated with Armolipid Plus® (N. 15/20) reached the desired LDL-C target, while 50% of pravastatin treated patients (N. 10/20) and 80% of the Armolipid Plus® treated ones reached the desired TG target (N. 16/20). No one adverse event has been registered during Armolipid Plus®, while 1 patient claimed myalgia and 1 reported significant increase of CPK (> 3 ULN) during pravastatin treatment. Both patients were then treated with Armolipid Plus® with resolution of symptoms and CPK increase, respectively.
Conclusion: In hypertriglyceridemic patients treated with fenofibrate, the association with a combined lipid lowering nutraceutical seem to be more effective in optimizing residual hypertriglyceridemia than pravastatin 40 mg, while being more tolerable and having similar effect on LDL-C plasma level
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