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Diagram of the pathophysiological effects of cigarette smoking. The main biologically active ingredients in cigarette smoke are nicotine, carbon monoxide and various other oxidant gases. ↑ Increased; BP Blood pressure; CNS Central nervous system; HR Heart rate. Reproduced with permission from reference 122

Diagram of the pathophysiological effects of cigarette smoking. The main biologically active ingredients in cigarette smoke are nicotine, carbon monoxide and various other oxidant gases. ↑ Increased; BP Blood pressure; CNS Central nervous system; HR Heart rate. Reproduced with permission from reference 122

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Hypertension, myocardial infarction, atherosclerosis, arrhythmias and valvular heart disease, coagulopathies and stroke, collectively known as cardiovascular diseases (CVDs), contribute greatly to the mortality, morbidity and economic burden of illness in Canada and in other countries. It has been estimated that over four million Canadians have hig...

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... of these combined actions of cigarette smoking play an important role in the initiation and development of CVD. A diagram of the pathophysiological actions of cigarette smoking and acute coronary events is shown in Figure 7 (122). ...

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... It was estimated that the global age-standardized prevalence of arterial hypertension was 24% in men and 20% in women in 2015 [3]. Established risk factors for the development of arterial hypertension are male sex, increased age, obesity, physical inactivity, stress, high salt intake, high alcohol consumption and predisposing genetic factors [4,5]. There are two traditional working hypotheses for the mechanisms leading to arterial hypertension. ...
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Aim: Aim of this study was to investigate the association between periodontitis and arterial hypertension, both of which show correlations with classical cardiovascular risk factors and inflammatory activity. Materials and methods: A cross-sectional analysis of data from a large population-based health survey (the Hamburg City Health Study, HCHS) including 5934 participants with complete periodontal examination and blood pressure data, of whom 5735 had medical records regarding anti-hypertensive medication, was performed. Probing depths, gingival recessions, bleeding on probing (BOP), dental plaque, and decayed-missing-filled teeth (DMFT) indices were recorded as measures of oral health. Clinical attachment loss (CAL) per tooth was calculated and periodontitis was staged into three groups (no/mild, moderate, severe). Arterial hypertension was diagnosed based on the participants' medication history and systolic and diastolic blood pressure values. Logistic regression models were constructed accounting for a set of potential confounders (age, sex, smoking, body mass index (BMI), diabetes, educational level, alcohol intake) and high sensitivity-C-reactive protein (hsCRP). Results: The odds of arterial hypertension increased significantly along with periodontitis severity (OR for severe periodontitis: 2.19; 95% CI 1.85-2.59; p < 0.001; OR for moderate periodontitis: 1.65; 95% CI 1.45-1.87; p < 0.001). Participants with moderate or severe periodontitis also had significantly higher age- and sex-adjusted odds of arterial hypertension, which was slightly weakened when additionally adjusted for BMI, diabetes, smoking, educational level, and alcohol intake (OR for severe PD: 1.28, 95% CI 1.04-1.59, p = 0.02; OR for moderate PD: 1.30, 95% CI 1.11-1.52, p = 0.001). The fraction of participants with undertreated hypertension (untreated and poorly controlled hypertension) was considerably larger in participants with severe periodontitis than in those with no/mild periodontitis (50.1% vs. 37.4% for no/mild periodontitis). Conclusions: The study shows an association between periodontitis and arterial hypertension that is independent of age, sex, diabetes, BMI, smoking, educational level, and alcohol intake. In addition, undertreatment of hypertension was more common in people with severe periodontitis compared with periodontally more healthy people.
... Cardiovascular disease (CVD) is responsible for the greatest proportion of premature non-communicable chronic disease (NCD) mortality globally (1). Increasing evidence has suggested that shared lifestyle and biological risk factors, such as unhealthy diet, hypertension, physical inactivity, dyslipidemia, and obesity may increase incident CVD risk (2,3). As a strategy for reducing CVD risk and overall premature NCD mortality, the World Health Organization (WHO) has given special emphasis to reducing these risk factors (4). ...
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Objective To quantify the association between ideal cardiovascular health (CVH) metrics and incident cardiovascular disease (CVD) including different subtypes [coronary heart disease (CHD), stroke, and sudden death], and all-cause mortality in an Iranian population. Methods The study population included 6,388 participants (2,726 men) aged 48.0 ± 12.4 years free of CVD at baseline. We utilized the American Heart Association’s 2020 impact target criteria of ideal, intermediate, and poor CVH. The multivariate Cox proportional Hazard model, adjusted for age, sex, educational level, marital status, and family history of CVD, was applied to estimate the hazard ratio (HR) of outcomes per one additional metric of ideal CVH metrics. Furthermore, the risk was also calculated for ideal and intermediate categories considering poor category as a reference. Results During the median follow-up of 11.26 years, 692 CVD, 589 CHD, 130 stroke, 111 sudden death, and 519 all-cause mortality events were reported. All of the individual ideal CVH metrics were independent predictors except intermediate physical activity level for CVD, BMI < 25 kg/m ² , and intermediate physical activity for all-cause mortality. Each additional metrics of ideal CVH decreased the risk by 31 (0.69, 0.65–0.73) for CVD, 32 (0.68, 0.64–0.73) for CHD, 31 (0.69, 0.60–0.80) for stroke, 25 (0.75, 0.64–0.88) for sudden death, and 13% (0.87, 0.81–0.93) for all-cause mortality events. Moreover, intermediate and ideal categories of CVH metrics were associated with lower risk for different CVD outcomes, i.e., 44 (0.56, 0.48–0.65) and 76% (0.24, 0.17–0.35) for CVD; 43 (0.57, 0.47–0.67) and 75% (0.25, 0.16–0.37) for CHD, 58 (0.42, 0.29–0.61) and 86% (0.14, 0.04–0.44) for stroke; 56 (0.44, 0.29–0.66) and 55% (0.45, 0.21–0.99) for sudden death; and 25 (0.75, 0.62–0.90) and 46% (0.54, 0.37–0.80) for all-cause mortality events, respectively. We also assessed the impact of changes in ideal CVH status from phase III to phase IV (2008–2011) on CVD events among 5,666 participants. Accordingly, compared to those remaining in the poor category, all of the changes in ideal CVH categories showed a lower risk for CVD events. Conclusion Among the Iranian population, meeting higher ideal CVH metrics is associated with a lower risk of different CVD events and mortality outcomes.
... Unfortunately, these numbers tend to increase as several non-modifiable and modifiable risk factors associated with the onset and development of these disorders are also escalating. While non-modifiable risk factors such as aging, gender, genetic predisposition, family history of heart-related problems and ethnicity cannot be altered [3][4][5], modifiable risk factors are changeable. These include hypertension, dyslipidaemia, diabetes, obesity, smoking, alcohol misuse, unhealthy diet, sedentary lifestyle, and psychosocial factors [6] and are recognised as relevant targets to manage CVDs. ...
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Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide and, together with associated risk factors such as diabetes, hypertension, and dyslipidaemia, greatly impact patients’ quality of life and health care systems. This burden can be alleviated by fomenting lifestyle modifications and/or resorting to pharmacological approaches. However, due to several side effects, current therapies show low patient compliance, thus compromising their efficacy and enforcing the need to develop more amenable preventive/therapeutic strategies. In this scenario, medicinal and aromatic plants are a potential source of new effective agents. Specifically, plants from the Allioideae subfamily (formerly Alliaceae family), particularly those from the genus Allium and Tulbaghia, have been extensively used in traditional medicine for the management of several CVDs and associated risk factors, mainly due to the presence of sulphur-containing compounds. Bearing in mind this potential, the present review aims to gather information on traditional uses ascribed to these genera and provide an updated compilation of in vitro and in vivo studies validating these claims as well as clinical trials carried out in the context of CVDs. Furthermore, the effect of isolated sulphur-containing compounds is presented, and whenever possible, the relation between composition and activity and the mechanisms underlying the beneficial effects are pointed out.
... Cardiovascular diseases (CVDs) such as myocardial infarction (MI), coronary artery disease (CAD) and heart failure (HF) are major contributors to global mortality rate. Large number of population is at the risk of developing MI, due to unhealthy dietary habits, smoking, diabetes, genetic predisposition, hypertension, lack of physical activity etc. [1]. CVDs can present at any age and across all demographic ranges. ...
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Acute myocardial infarction (MI) is found to be a major causative factor for global mortality and morbidity. This situation demands necessity of developing efficient and rapid diagnostic tools to detect acute MI. Raman spectroscopy is a non-destructive optical diagnostic technique, which has high potential in probing biochemical changes in clinical samples during initiation and progress of diseases. In this work, blood was taken as the sample to examine inflammation in acute MI patients using Raman spectroscopy. Ratio of Raman peak intensities that corresponds to phenylalanine (1000 cm ⁻¹ ) and tyrosine (825 cm ⁻¹ ) can facilitate indirect information about tetrahydrobiopterin (BH4) availability, which can indicate inflammatory status in patients. This ratio obtained was higher for MI patients in comparison with control subjects. The decrease in phenylalanine and tyrosine ratio (Phe-Tyr ratio) is attributed to the prognosis of standard of care (medications like antiplatelets including aspirin, statin and revascularisation) leading to inflammation reduction. Phe-Tyr ratio estimated from the Raman spectra of blood can be exploited as a reliable method to probe inflammation due to MI. The method is highly objective, require only microliters of sample and minimal sample preparation, signifying its clinical utility.
... In line with digestion and exercise, those whose digestion was poor and could hardly sustain exercise were prone to prehypertension. Low appetite and little or no exercise could result in improper assimilation of metabolites resulting in disorders (Buttar et al. 2005). ...
... This phenomenon is due to blood clots or the buildup of fatty plaques in the inner walls of blood vessels [4]. Cigarette smoking, obesity, physical inactivity, hypertension, diabetes, and hyperlipidemia are the most frequent reasons associated with heart attacks [5]. ...
Article
Cardiac patches made up of polymer scaffolds and heart muscle cells have received great attention as a promising construct to repair damaged heart tissue and improve its function. There are various techniques, including solvent casting, electrospinning, and rotary-jet spinning, which are widely used for the fabrication of cardiac patches from natural, synthetic, or natural/synthetic polymers. However, limited control over the structure of patches and poor reproducibility are some of the drawbacks associated with these fabrication methods. Currently, the development of additive manufacturing 3D bioprinting technology has opened a new avenue for tissue engineering applications. 3D bioprinting techniques allow the fabrication of cardiac patches with a flexible design based on the individual patient's needs to be placed in precise geometries as found in native counterparts. Recent research has focused on the improvement and implementing various functionalities of cardiac patches. Electroconductive, drug delivery, 4D, and shape memory cardiac patches are the most recent advances in cardiac patch manufacturing. With all these developments, adhesion of the cardiac patches to heart tissue with a slippery wet surface and under dynamic forces has been challenging. The materials and strategies developed for ideal adhesion to the heart tissue are also reviewed in this paper.
... [27][28][29] Questions on the role of community pharmacists in CVD prevention and management and barriers to CV health promotion were modified from literature. [30][31][32] The questionnaire was developed in English language (see File S1). The pilot study was conducted with ten (10) community pharmacists in the Ashanti region of Ghana. ...
... This result builds on existing evidence of preventive strategies against CVDs which should be done at the primary health promotion level before a person, or the population becomes afflicted with some of the causes of CVD. 30 Again, a study in Lebanon affirms the observation that including pharmacists in CVD prevention plan can improve CVD prevention by decreasing the risk factors. 41 With the involvement of community pharmacists in CVD preventive activities, the risk factors of CVD including hypertension, diabetes, smoking, physical inactivity, and hypercholesterolemia can be prevented by constantly monitoring and educating clients on these risk factors. ...
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Background: Globally, Cardiovascular Diseases (CVDs) are the leading non-communicable diseases with a high mortality if not detected and managed early. The study assessed community pharmacists' perception and determined their role in CVDs prevention and management. Method: A cross-sectional study was conducted among 103 registered community pharmacists in the Ahafo, Bono and Bono East regions of Ghana. Data was collected using validated questionnaires through an online and in-person surveys. The data was analysed using Microsoft Excel and STATA 14.1. Results: Community Pharmacists had knowledge on the concept of pharmaceutical care (n = 93, 92.2%). The roles that Pharmacists played in CVD management and control included educating clients on their conditions and drug therapy, checking for possible drug interactions and screening for risk factors. The barriers to CV health promotion were increase of the pharmacist's workload (n = 96, 93.2%), lack of time (n = 91, 88.4%) and lack of CVD educational materials and clinical tools (n = 56, 54.4%). Conclusion: Community pharmacists have a positive perception of their role in CVDs and performed various activities to reduce the burden of CVDs. However, cardiovascular health promotion in community pharmacies is hindered by increase of the pharmacist's workload, lack of time and lack of CVD educational materials.
... Such risk factors typically include lipid profile (i.e., total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG)), blood pressure (BP), obesity, diabetes, and cigarette smoking (Wilson et al., 1998). There is growing evidence showing that these risk factors lie in the causal pathway between environmental exposure and downstream CHD events or mortality outcomes (Buttar et al., 2005;Sharif et al., 2019). Thus, it is of great interest to understand and estimate the additional proportion of variation in disease outcomes explained by environmental risk factors through these putative mediating pathways. ...
... Previous research suggest that increased smoking or smoking paired with drinking and other factors may be responsible for increases in TC, LDL-C, and TG, as well as decreases in HDL-C (Gossett et al., 2009;Miocevic et al., 2006;Vodnala et al., 2012). Therefore, several or all risk factors may work together to confer the risk of heart diseases (Buttar et al., 2005;Jousilahti et al., 1996). To this end, we would like to untangle this research "puzzle" in order to understand why and how these factors work together to contribute to the occurrence of clinical outcomes by mediation analysis. ...
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There is an increasing trend of research in mediation analysis for survival outcomes. Such analyses help researchers to better understand how exposure affects disease outcomes through mediators. However, due to censored observations in survival outcomes, it is not straightforward to extend mediation analysis from linear models to survival outcomes. In this article, we extend a mediation effect size measure based on $R^2$ in linear regression to survival outcomes. Due to multiple definitions of $R^2$ for survival models, we compare and evaluate five $R^2$ measures for mediation analysis. Based on extensive simulations, we recommend two $R^2$ measures with good operating characteristics. We illustrate the utility of the $R^2$-based mediation measures by analyzing the mediation effects of multiple lifestyle risk factors on the relationship between environmental exposures and time to coronary heart disease and all-cause mortality in the Framingham Heart Study.
... In particular, NDCs such as β-glucan and FOS have been shown to lower blood cholesterol because their viscous properties interfere with the absorption of cholesterol and bile acids in the intestine and reduce lipase activity [75]. Decreased reabsorption of bile acid leads to increased hepatic conversion of cholesterol into bile acid; as a result, more cholesterol stored in the body is used to produce bile acid [76]. NDCs also enhance digestive regularity by promoting rapid gastric emptying, decreasing intestinal transit time, and increasing fecal bulk [75]. ...
Article
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Metabolic diseases (MDs), including cardiovascular diseases (CVDs) and diabetes, occur when the body’s normal metabolic processes are disrupted. Behavioral risk factors such as obesity, physical inactivity, and dietary habits are strongly associated with a higher risk of MD. However, scientific evidence strongly suggests that balanced, healthy diets containing non-digestible carbohydrates (NDCs), such as dietary fiber and resistant starch, can reduce the risk of developing MD. In particular, major properties of NDCs, such as water retention, fecal bulking, viscosity, and fermentation in the gut, have been found to be important for reducing the risk of MD by decreasing blood glucose and lipid levels, increasing satiety and insulin sensitivity, and modifying the gut microbiome. Short chain fatty acids produced during the fermentation of NDCs in the gut are mainly responsible for improvement in MD. However, the effects of NDCs are dependent on the type, source, dose, and duration of NDC intake, and some of the mechanisms underlying the efficacy of NDCs on MD remain unclear. In this review, we briefly summarize current studies on the effects of NDCs on MD and discuss potential mechanisms that might contribute to further understanding these effects.
... It is estimated that up to 90% of CVDs may be preventable if the modifiable risk factors are addressed. However, knowledge of modifiable risk factors can vary from one region to another (3). A notable decline in cardiovascular deaths has been shown as a result of controlling modifiable risk factors, which apparently emphasize the role of preventive medicine (4). ...
Article
Objective: Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels that occur due to different risk factors. studies had shown that controlling these factors can result in lower mortality rate. Therefore, the objective of this study was to investigate the attitude, knowledge, and practice regarding cardiovascular modifiable risk factors among nursing staff in a tertiary hospital in Riyadh. Materials and methods: A cross-sectional study was conducted between January 2020-October 2020 in King Salman Heart Center at King Fahad Medical City (KFMC). Data were obtained utilizing a self-administered questionnaire completed by 121 nurses. Analysis of the data was done using IBM SPSS version 26 (IBM Corp., Armonk, NY, USA). Results: The majority of the participants did not have any CVDs' risk factors. However, physical inactivity, obesity, unhealthy eating, and smoking were frequent in a substantial number of the participants. It was found that 71.07% of nurses had good knowledge, a positive attitude (61.98%), and most of them were following a fair nursing practice (67.77%). Conclusion: Overall, we found that the participating nurses had a good knowledge, fair attitude and good practice about the modifiable risk factors of CVD which urges launching initiatives for CVD risk prevention in KFMC, however, awareness campaigns are recommended to educate the nurses more with the state-of-the-art knowledge in this area.