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A 50-year history of the health impacts of Westernization on the lifestyle of Japanese Americans: A focus on the Hawaii-Los Angeles-Hiroshima Study.
Yoneda, M, Kobuke, K
Journal of diabetes investigation. 2020;(6):1382-1387
Abstract
A medical survey of Japanese Americans have been carried out since 1970; in particular, this survey was administered to the Japanese emigrants from Hiroshima (Japan) to Hawaii or Los Angeles (USA) and their offspring. Labeled the Hawaii-Los Angeles-Hiroshima Study, it constituted a long-term epidemiological study of Japanese Americans who are genetically identical to the native Japanese people, but have experienced rapid and intense Westernization in terms of their lifestyles. The authors have compared the medical survey data procured from two Japanese populations, evincing very disparate lifestyles; that is, the native Japanese inhabitants of Hiroshima (Japan) and Japanese Americans living in Hawaii or Los Angeles (USA). The focus was particularly on differences in the intake of nutrients, the frequency of obesity, the prevalence of metabolic syndrome and diabetes mellitus, and the progression of atherosclerosis. The authors believe that the health effects of the lifestyles of Japanese Americans can predict the imminent health prospects of native Japanese people who adopt Westernized lifestyles in Japan. This review thus summarized the major results accumulated from the Hawaii-Los Angeles-Hiroshima Study over the past 50 years.
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The Role of Nutraceuticals in the Optimization of Lipid-Lowering Therapy in High-Risk Patients with Dyslipidaemia.
Penson, PE, Banach, M
Current atherosclerosis reports. 2020;(11):67
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Abstract
PURPOSE OF REVIEW We aimed to summarize recent guidelines, position papers, and high-quality clinical research relating the use of nutraceuticals in the management of individuals at high risk of atherosclerotic cardiovascular disease. RECENT FINDINGS It is essential that individuals at high risk of cardiovascular disease receive guideline-directed evidence-based therapies to reduce their risk of morbidity and mortality from cardiovascular events. Compared with conventional therapeutics, nutraceuticals have undergone relatively little investigation in randomized controlled trials. Thus, recommendations for nutraceuticals in international guidelines are rare, and nutraceuticals should not be used preferentially in place of statins. Nevertheless, recent position papers from the International Lipid Expert Panel and clinical evidence from studies of triglyceride reduction by polyunsaturated fatty acid administration demonstrate that nutraceuticals do have an important role in optimizing therapy in individuals at high risk of cardiovascular disease. Roles for nutraceuticals include as follows: (1) managing residual risk associated with lipids other than low-density lipoprotein cholesterol (LDL-C); (2) managing non-lipid-mediated residual risk; (3) optimizing LDL-C treatment in statin intolerance; (4) optimizing LCL-C treatment when add-on therapies for statins are not available; (5) as adjuncts to lifestyle for individuals at high lifetime risk of atherosclerotic cardiovascular disease (ASCVD). The strength of evidence for each of these applications is variable. In addition to guideline-directed therapeutics, nutraceuticals may have roles in optimizing preventative therapy and targeting residual risk in individuals at high risk of ASCVD. Application of Good Manufacturing Practice and randomized controlled trials when producing and evaluating nutraceuticals will expand the armoury of evidence-based agents for the prevention of ASCVD.
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A performance guide for major risk factors control in patients with atherosclerotic cardiovascular disease in Taiwan.
Li, YH, Chen, JW, Lin, TH, Wang, YC, Wu, CC, Yeh, HI, Huang, CC, Chang, KC, Wu, CK, Chen, PW, et al
Journal of the Formosan Medical Association = Taiwan yi zhi. 2020;(3):674-684
Abstract
Atherosclerotic cardiovascular disease (ASCVD), including coronary artery disease, cerebrovascular disease, and peripheral artery disease, carries a high morbidity and mortality. Risk factor control is especially important for patients with ASCVD to reduce recurrent cardiovascular events. Clinical guidelines have been developed by the Taiwan Society of Cardiology, Taiwan Society of Lipids and Atherosclerosis, and Diabetes Association of Republic of China (Taiwan) to assist health care professionals in Taiwan about the control of hypertension, hypercholesterolemia and diabetes mellitus. This article is to highlight the recommendations about blood pressure, cholesterol, and sugar control for ASCVD. Some medications that are beneficial for ASCVD were also reviewed. We hope the clinical outcomes of ASCVD can be improved in Taiwan through the implementation of these recommendations.
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Mitral Annular Calcification: Association with Atherosclerosis and Clinical Implications.
Cavalcanti, LRP, Sá, MPBO, Perazzo, ÁM, Escorel Neto, AC, Gomes, RAF, Weymann, A, Zhigalov, K, Ruhparwar, A, Lima, RC
Current atherosclerosis reports. 2020;(2):9
Abstract
PURPOSE OF REVIEW This review summarizes the pathophysiology of mitral annular calcification (MAC) with recent findings and current strategies for diagnosis and treatment. RECENT FINDINGS Major factors in MAC development seem to be shear stress of the flow past the mitral valve, local inflammation, and dysregulation in regulators of mineral metabolism. MAC itself poses daunting technical challenges. Implanting a valve on top of the calcium bar might lead to paravalvular leak (PVL) that is less likely to heal. Annular decalcification allows for better valve seating and potentially better healing and less PVL. This, however, comes with the risk for catastrophic atrioventricular groove disruption. MAC can be sharply dissected with the scalpel; the annulus can be reconstructed with the autologous pericardium. Transcatheter mitral valve replacement is a promising approach in the treatment of patients who are deemed high-risk surgical candidates with severe MAC. MAC is a multifactorial disease that has some commonalities with atherosclerosis, mainly regarding lipid accumulation and calcium deposition. It is of great clinical importance, being a risk marker of cardiovascular events (including sudden death) and, with its progression, can have a negative impact on patients' lives.
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LDL-cholesterol reduction in chronic kidney disease: options beyond statins.
Goonasekera, MA, Mafham, MM, Haynes, RJ
Current opinion in nephrology and hypertension. 2020;(5):480-488
Abstract
PURPOSE OF REVIEW Individuals with chronic kidney disease (CKD) are at increased risk of atherosclerotic cardiovascular disease (ASCVD) events. LDL cholesterol (LDL-C) is a key modifiable cause of ASCVD and lowering LDL-C with statins reduces the risk of ASCVD events in a wide range of populations, including those with CKD. This review considers the utility of recently developed nonstatin LDL-C-lowering therapies in CKD. RECENT FINDINGS The cholesterol absorption inhibitor, ezetimibe, reduces LDL-C by 15-20% and is well tolerated in CKD. Monoclonal antibodies (mAbs) targeting proprotein convertase subtilisin kexin type 9 (PCSK9) reduce LDL-C by 50-60% and reduce the risk of ASCVD events. However, these agents require self-administration by subcutaneous injection every 2-4 weeks. The PCSK9 synthesis inhibitor, inclisiran, is administered approximately 6 monthly and may be more suitable for widespread use, although outcome trials are awaited. These PCSK9 targeting therapies require no dose adjustment in CKD and have no drug interactions. SUMMARY Statins and ezetimibe are safe and reduce ASCVD risk in CKD populations. PCSK9 targeting agents may be useful in high-risk CKD patients, including those with prior ASCVD.
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Atherosclerosis prevention: the role of special diets and functional food.
Karagodin, VP, Sukhorukov, VN, Orekhov, AN, Yet, SF, Sobenin, IA
Frontiers in bioscience (Elite edition). 2020;(1):95-101
Abstract
Accumulating evidence highlight the importance of diet in the pathogenesis as well as prevention of atherosclerosis. In this review, we summarize the results of recent studies that demonstrate direct and indirect effects if functional foods and their analogues in prevention of initiation and progression of atherosclerosis. We discuss the epidemiological and clinical observations of such diets and dicuss their effects on the pathological mechanisms that drive atherosclerosis at cellular and molecular level.
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Incidence of Hospitalization for Heart Failure Relative to Major Atherosclerotic Events in Type 2 Diabetes: A Meta-analysis of Cardiovascular Outcomes Trials.
Sacre, JW, Magliano, DJ, Shaw, JE
Diabetes care. 2020;(10):2614-2623
Abstract
BACKGROUND Emerging evidence points to heart failure as being a common first presentation of cardiovascular (CV) disease in type 2 diabetes. PURPOSE The purpose of this study was to determine whether hospitalization for heart failure (HHF) occurs more or less frequently than major adverse CV events (MACE) in people with type 2 diabetes. DATA SOURCES Placebo arms of CV outcomes trials in type 2 diabetes were included. STUDY SELECTION Sixteen CV outcomes trials were selected, including five dipeptidyl peptidase 4 inhibitor trials, seven glucagon-like peptide 1 receptor agonist trials, and four sodium-glucose cotransporter 2 inhibitor trials. DATA EXTRACTION We extracted incidence rates of HHF, myocardial infarction (MI), stroke, and the composite outcomes of CV death or HHF and MACE (CV death, nonfatal MI, or nonfatal stroke). DATA SYNTHESIS In two trials enriched with people with chronic kidney disease, HHF was more common than both MI and stroke. Among the remaining 14 trials, HHF was less frequent than MI in 13 (93%), with this difference being significant in 8 (57%); however, HHF surpassed stroke in all but 1 study (93%; significant in 7 studies [50%]). Heterogeneity among trials was moderate/high (I 2 >50%) and partly explained by HHF/MI correlating with age and previous MI history (P < 0.05). In seven trials that reported events stratified by presence/absence of preexisting CV disease, ratios of HHF/MI and HHF/stroke were similar between groups. LIMITATIONS Enrichment of trial populations with those at high risk of CV events limits generalizability. CONCLUSIONS Although less frequent than MI, HHF is a common event in type 2 diabetes, both in those with and those without prior CV disease.
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Efficacy of Statin/Ezetimibe for Secondary Prevention of Atherosclerotic Cardiovascular Disease in Asian Populations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Bhagavathula, AS, Aldhaleei, WA, Al Matrooshi, NO, Rahmani, J
Clinical drug investigation. 2020;(9):809-826
Abstract
BACKGROUND Several clinical trials have investigated the effect of statin/ezetimibe combination therapy on secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in the Asian population. OBJECTIVE This study aimed to summarize study results regarding the effect of statin/ezetimibe combination therapy on lipid parameters and highly sensitive C-reactive protein (HsCRP) biomarkers in ASCVD patients from Asian countries. METHODS We searched the PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar databases for relevant papers published from 2008 to June 2020. We included randomized controlled trials (RCTs) that (1) were conducted in ASCVD patients in Asian countries; (2) examined the effects of statin/ezetimibe combination therapies compared with a control group; and (3) reported sufficient data on lipid parameters and HsCRP biomarkers. The results were reported as weighted mean differences (WMDs) with 95% confidence intervals (CI) using random-effects models. Funnel plots and Egger's regression test were used to assess publication bias. RESULTS Twenty-four RCTs were reviewed and 20 were included in the meta-analysis. A total of 4344 participants were included (n = 2197 in the intervention group and n = 2147 in the control group), and the intervention durations ranged from 6 weeks to 3.6 years. Ezetimibe coadministered with statin therapy, compared with control treatment, significantly reduced low-density lipoprotein cholesterol (LDL-C; n = 20 studies) [WMD - 0.39 mmol/L, 95% CI - 0.73 to - 0.05; p < 0.001], triglycerides (TG; n = 18 studies) [WMD - 0.23 mmol/L, 95% CI - 0.33 to - 0.13; p < 0.001], and total cholesterol (TC; n = 17 studies) [WMD - 0.31 mmol/L, 95% CI - 0.45 to - 0.17; p < 0.001). Although the effect of statin/ezetimibe combinations on high-density lipoprotein cholesterol (HDL-C; n = 17 studies) [WMD 0.02 mmol/L, 95% CI - 0.05 to 0.09; p < 0.001) was very minimal and no effect was observed on HsCRP levels (n = 11 studies). CONCLUSIONS Our study found that statin/ezetimibe combinations reduced LDL-C, TC, and TG levels but had minimal effects on HDL-C and no effect HsCRP biomarkers in ASCVD patients. The statin/ezetimibe therapy enabled a more effective reduction in LDL-C levels; however, the duration of the treatment was suboptimal.
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Insights into pharmacological mechanisms of polydatin in targeting risk factors-mediated atherosclerosis.
Ahmad, P, Alvi, SS, Iqbal, D, Khan, MS
Life sciences. 2020;:117756
Abstract
Polydatin (PD) is a monocrystalline metabolite from the underground parts of Polygonum cuspidatum Sieb. et Zucc., a member of the Polygonaceae family, which has been traditionally used in Asian countries as both foodstuffs and medicine. PD, also reckoned as pieceid, 3,4',5-trihydroxystilbene-3-β-D-glucoside, (E)-piceid, (E)-polydatin, and trans-polydatin. It possesses potent biological activities i.e. analgesic, anti-inflammatory, antidiabetic, anticancer, and anti-atherosclerotic properties. The initial part of this report specifically explains distinct sequential mechanisms underlying the initiation and development of atherosclerotic plaques and later part deals with the pharmacological efficacy of PD in the management of major cardiac event i.e. atherosclerotic cardiovascular diseases (ASCVD) via modulation of a set of molecular mechanisms i.e. antioxidant potential, lipid and lipoprotein metabolism including total cholesterol (TC) and low density lipoprotein (LDL) levels, β-hydroxy-β-methyl-glutaryl-CoA reductase (HMG-R) expression and functionality, SIRT signalling, LDL-receptor (LDL-R), LDL oxidation status (Ox-LDL), effects on endothelial cells (ECs), smooth muscle cells (SMCs), macrophage, foam cell formation and plaque stabilization, inflammatory signalling pathways and hypertension. In contrast, one of the major insight into the potential cardioprotective molecular mechanism is the PD-mediated targeting of proprotein convertase subtilisin/kexin type-9 (PCSK-9) and LDL-R pathway, both at transcriptional and protein functional level, which makes it a better alternative therapeutic medicinal candidate to treat hypercholesterolemia, especially for the patients facing inadequate lipid lowering with classical HMG-R inhibitors (statins) and statin intolerance. Finally, to sum up the whole, we concluded that PD may be promoted from alternative to mainstream medicine in targeting risk factors mediated ASCVD.
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A significant role of permeability on blood flow for hybrid nanofluid through bifurcated stenosed artery: Drug delivery application.
Shahzadi, I, Bilal, S
Computer methods and programs in biomedicine. 2020;:105248
Abstract
OBJECTIVE The prime objective of concerned article is to discuss the permeability impacts on blood flow by considering hybrid nanofluid through bifurcated stenosed artery. DESIGN/APPROACH The human body circulatory framework involves the arrangement of veins that fuse the bifurcation on parent, at apex and on regions of daughter artery with nanoparticles is viewed. Blood streaming is recognized as Newtonian along vessel segment. The walls of the stenosed bifurcated artery is considered to be permeable as well as compliant. Copper and its oxide as used as drug to minimize the stress and the lesions of the atherosclerotic artery. FINDINGS The theoretical investigation is carried out by invoking the experimental values of hybrid nanoparticles into the structured equations. Moreover, impacts of hemodynamics are also make sense of to inspect the progression of blood for atherosclerotic vein. Daughter and parent artery comparison is described through parabolic graph of velocity. Graphical illustration is utilized to present the theoretical results of this drug delivery model. Metallic nanoparticles justify their use in drug delivery. CONCLUSIONS The flow of blood is viewed as not quite the same as pressure between segments of atherosclerotic and non-atherosclerotic course. Bifurcation angle minimize the stress for daughter artery whereas trend is opposite for parent daughter. The change in compliant wall parameter reduces the circulating bolus size for parent daughter whereas for daughter artery the change in bolus shape is observed.