The Different Facets of Dyslipidemia and Hypertension in Atherosclerosis

Recent advancements in dual-locked optical probe for precise imaging of atherosclerosis

Atherosclerosis (AS) is the primary pathological basis for cardiovascular and cerebrovascular events, making early diagnosis and dynamic risk assessment crucial for reducing the incidence of thrombotic occurrences. Traditional imaging techniques, such as CT, MRI, and PET, provide morphological information about plaques; however, they are limited in their ability to detect the molecular activity characteristics of these plaques, which hampers the assessment of thrombotic risk. In recent years, molecular optical probes have offered new insights into plaque activity detection by targeting specific biomarkers. However, single-target probes often produce false positive signals due to the cross-expression of biomarkers, which limits their clinical application. To overcome this challenge, dual-lock optical probes have been developed, achieving dual-target synergistic activation, which significantly enhances the specificity and signal-to-noise ratio of imaging. This article reviews the targeted imaging strategies and recent advancements in dual-lock optical probes in the context of AS, with a particular emphasis on their application in lipid droplet enrichment, oxidative stress, and specific enzymes. Although the technology still faces challenges regarding sensitivity, specificity, and multi-target design, its potential for future development is substantial. Through interdisciplinary collaboration and technological innovation, dual-lock optical probes are poised to evolve from 'imaging tools' to 'integrated diagnosis and treatment platforms', thereby advancing the precise diagnosis and treatment of complex diseases.

Systematic analysis of the burden of ischemic stroke attributable to high LDL-C from 1990 to 2021

Background

Low-density lipoprotein cholesterol (LDL-C) is a public health concern linked to ischemic stroke. The study aimed to describe the epidemiological characteristics of ischemic stroke attributable to high LDL-C from 1990 to 2021.

Methods

In this study, we analyzed data from the Global Burden of Disease 2021 to present trends in ischemic stroke related to high LDL-C over the past 30 years. The relationship between disease burden and the Socio-Demographic Index (SDI) was examined. To assess international health disparities, we applied the Slope Index of Inequality (SII) and the Concentration Index (CI). Furthermore, we conducted a frontier analysis to identify areas for improvement and developmental gaps among nations, and employed the Bayesian Age-Period-Cohort (BAPC) model to forecast the disease burden for the next 15 years.

Results

In 2021, the incidence of ischemic stroke attributed to high LDL-C significantly increased compared to 1990, with a more pronounced growth rate in males. The burden mainly affects individuals aged 70 to 84. Analysis using the age-period-cohort model indicates that mortality rates and DALYs rise with age, while period and cohort effects exhibit a gradual decline. Across different SDI regions, trends generally follow a similar downward path, with a narrowing gap in disease burden among regions with varying SDI levels. However, the disease burden in high SDI countries remains significant, indicating potential for reduction. Predictions for the next 15 years suggest that while the global disease burden will decrease, there may be an increase among individuals under 55.

Conclusion

Compared to 1990, the overall age-standardized burden of ischemic stroke related to high LDL-C has been controlled. However, disparities persist across different SDI regions. We have observed an increasing burden among younger populations. Consequently, countries and regions must adopt new measures tailored to their SDI levels, with a specific emphasis on younger individuals. It is essential to develop prevention and treatment strategies aimed at high-risk groups.

New Roles of Artemisinins in Atherosclerosis Progression

Artemisinin is a natural compound derived from the Chinese plant Artemisia annua , which was officially approved by the FDA for its antimalarial effects. In recent years, a growing body of studies has shown the novel function of artemisinin in atherosclerosis therapy. In vivo studies have shown that artemisinin can inhibit the progression of atherosclerosis plaque. In the present review, the evidence showing the inhibitory effects of artemisinin on the progression of atherosclerosis plaque and its underlying mechanisms is discussed. Mechanistically, artemisinin and its derivatives act by modulating various atherosclerosis-mediating risk factors, including hyperlipidemia, inflammation, oxidative stress, and malfunctioning vascular smooth muscle cells (VSMCs). Notably, artesunate, but not artemisinin, can attenuate the plasma levels of TG, TC, VLDL-C, and LDL-c, along with a substantial decline in arterial lipid deposition through enhancing the LDPL activity via inducing the KFL2/NRF2/TCF7L2 axis. Artemisinin was found to ameliorate the atherosclerosis plaque inflammation by reducing monocyte adhesion and subsequent transmigration to the intima, via inhibiting the expression of ICAM-1 and VCAM-1, diminishing NLRP3 inflammasome activation, and reducing the expression of inflammatory factors such as IL-1β, IL-18, TNF-α, MCP-1, and TGF-β1 mechanistically and mainly via suppressing the by NF-κB activity. Artemisinin could exert antioxidant effects through activating the PI3K/Akt/eNOS signaling pathway and suppressing the ROS-mediated NF-κB signal pathway. Artemisinin could also improve the VSMC function in the atherosclerosis plaque. These findings can suggest artemisinin as a new therapeutic agent for treating atherosclerosis; however, future clinical trials are warranted to validate its therapeutic efficiency in patients with atherosclerosis.

Effects of exercise combined with different dietary interventions on cardiovascular health a systematic review and network meta-analysis

BACKGROUND

Numerous studies have shown that exercise and dietary interventions positively impact CVD outcomes; however, there is substantial variability in the efficacy of different interventions. The absence of direct comparisons between multiple interventions complicates the determination of their relative effects. This study aims to synthesize the literature on the impacts of exercise, dietary, and combined interventions on cardiovascular health indicators, and to perform a network meta-analysis to rank the efficacy of these approaches, providing a theoretical foundation for selecting optimal intervention strategies.

METHODS

We systematically reviewed the literature from database inception through September 2024, searching PubMed, Web of Science, Embase, and the Cochrane Library. Data were aggregated and analyzed using network meta-analysis, with intervention efficacy ranked according to Surface Under the Cumulative Ranking (SUCRA) curves.

RESULTS

The efficacy of these interventions was ranked as follows: 1). Triglycerides (TG) Reduction: CR + EX > CR > 5/2F + EX > TRF + EX > KD > 5/2F > KD + EX > EX > CON > TRF. 2). Total Cholesterol (TC) Reduction: CR + EX > CR > 5/2F + EX > 5/2F > TRF + EX > EX > CON > KD > TRF > KD + EX. 3). High-Density Lipoprotein (HDL) Increase: 5/2F > KD > KD + EX > TRF + EX > CON > EX > TRF > 5/2F + EX > CR + EX > CR. 4). Low-Density Lipoprotein (LDL) Reduction: CR + EX > CR > TRF + EX > KD + EX > EX > KD > 5/2F > CON > 5/2F + EX > TRF. 5). Systolic Blood Pressure (SBP) Reduction: 5/2F > CR + EX > CR > EX > TRF > TRF + EX > CON > 5/2F + EX. 6). Diastolic Blood Pressure (DBP) Reduction: CR > CR + EX > TRF > 5/2F > TRF + EX > EX > CON > 5/2F + EX.

CONCLUSION

CR and CR + EX demonstrated the most positive effects on cardiovascular health indicators. In contrast, 5/2F + EX ranked relatively low in effectiveness, with its impact on several indicators being even lower than that of CON.

Peripheral Arterial Disease in Diabetic Foot: One Disease with Multiple Patterns

Peripheral arterial disease (PAD) is a major complication in individuals with diabetes and is increasingly prevalent in those with diabetic foot ulcers (DFUs). Despite this, the characterisation of PAD in diabetic patients remains insufficiently refined, leading to suboptimal management and outcomes. This review underscores the necessity for a more nuanced understanding of PAD's anatomical and biological aspects in diabetic patients. The distribution of atherosclerotic plaques varies significantly among individuals, influencing prognosis and treatment efficacy. We describe three key patterns of PAD in diabetes: pattern 1 PAD-below-the-knee (BTK) disease (with infrageniculate disease where present); pattern 2-below-the-ankle (BTA) disease; and pattern 3-small artery disease (SAD), each presenting unique challenges and require tailored therapeutic approaches. BTK PAD, characterised by occlusions in the anterior tibial, posterior tibial, and peroneal arteries, necessitates targeted revascularisation to improve foot perfusion. BTA PAD, involving the pedal and plantar arteries, is associated with higher risks of amputation and requires advanced revascularisation techniques. SAD, affecting the small arteries of the foot, remains an enigma and is challenging to treat with the current mechanical methods, highlighting the potential of autologous cell therapy as a promising alternative. A refined characterisation of PAD in diabetes is crucial for developing effective, individualised treatment strategies, ultimately improving patient outcomes, and reducing the burden of diabetic foot complications. In light of these complexities, it is incredulous that we often use a single term, "peripheral arterial disease", to describe such a diverse array of disease patterns. This oversimplification can be perilous, as it may lead to inadequate therapeutic approaches and suboptimal patient care.

Non-high density lipoprotein cholesterol/high density lipoprotein cholesterol is L-shaped associated with all-cause mortality and U-shaped with cardiovascular mortality in hypertensive patients

Background

Patients with hypertension may have better survival rates when their lipid metabolism is in balance. The relationship between the novel composite lipid metric, NHHR, and all-cause and cardiovascular mortality in hypertensive patients remains unknown and warrants further investigation.

Methods

We analyzed data from 5,561 hypertensive participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. To determine the optimal NHHR cutoff point, we employed a maximum selection statistics approach. Participants were subsequently divided into groups for multivariate weighted Cox regression analysis. The association between NHHR and mortality risk was examined using restricted cubic splines (RCS). To investigate possible variations among different populations, subgroup analysis and interaction tests were carried out. The predictive capability of NHHR for survival outcomes was evaluated using time-dependent receiver operating characteristic (ROC) curves.

Results

Over a median follow-up period of 93 months, patients with hypertension exhibited an all-cause mortality rate of 21.78% and a cardiovascular mortality rate of 7.32%. A markedly elevated risk of cardiovascular death was associated with NHHR levels below 1.66 (HR 1.76; 95% CI 1.31-2.38; P < 0.001), as well as an increased risk of all-cause mortality (HR 1.58; 95% CI 1.31-1.91; P < 0.001). The RCS analysis revealed a U-shaped relationship with cardiovascular mortality (P = 0.0083) and an L-shaped correlation with all-cause mortality (P < 0.0001). Areas under the curve (AUC) for cardiovascular mortality were 0.97, 0.76, and 0.87, and for all-cause mortality were 0.76, 0.84, and 0.80 for the 3-year, 5-year, and 10-year survival periods.

Conclusions

The findings indicate that lower NHHR is associated with an increased risk of both cardiovascular and all-cause mortality, highlighting the critical need for comprehensive lipid management in the clinical management of hypertension. These results suggest that NHHR could serve as a valuable tool for identifying high-risk individuals for mortality, and should be incorporated into routine risk stratification assessments for hypertensive patients. This could more effectively improve patient prognosis and guide personalized treatment strategies.

Impact of combined high-intensity bodyweight interval training and breathing exercise on cardiometabolic health in normal-weight middle-aged adults with hypertension

BACKGROUND

High-intensity interval training and breathing exercises alone have well-documented health benefits in people with hypertension. This study aimed to investigated the effects of combining the two methods on physical health among adults with hypertension.

METHODS

Ninety-six adults (59.4 ± 9.1 years; 84% female; BMI 22.7 ± 1.6 kg/m2) with hypertension were randomized into one of four groups: Breathing Exercise (BE), High-Intensity Bodyweight Interval Training (HIBIT), Combined Exercise (CE), or a Non-Exercise Control (CON) group. The intervention lasted 10 weeks, with all exercise groups having the same total training time of 3 days per week (BE: 30 min/day; HIBIT: 60 min/day; CE: BE 30 min/day plus HIBIT 60 min/day). Resting heart rate, resting blood pressure, hand grip strength, cardiorespiratory fitness assessed using 6-Minute Walking Test (6MWT) and blood lipids were measured pre- and post-intervention.

RESULTS

The BE group showed the greatest reduction in systolic blood pressure (SBP) compared to CON, although differences among the exercise groups were not statistically significant. The increase in 6MWT values in the combined exercise group differed significantly compared to the other three groups (p = 0.000 and effect size = 0.296). The combined exercise group showed significant reductions in total cholesterol, LDL and triglyceride levels compared to the control group. The average reduction in total cholesterol levels was 20.8 mg/dL (95% C: -41.9 - 0.4) with an effect size of 0.103. Meanwhile, the decrease in LDL and triglyceride levels was 20.1 mg/dL (95% CI: -37.6--2.5; p = 0.014) and -40.4 mg/dL (95% CI: -82.1-1.3; p = 0.04) with effect sizes of 0.118 and 0.101.

CONCLUSIONS

In conclusion combined exercise for 10 weeks could lower systolic and diastolic blood pressure, increase CRF, and improved lipid profile. As a clinical implication, the results of this study can be an alternative or complementary approach to treatment for hypertension, potentially reducing the need for medications and their associated side effects.

TRIAL REGISTRATION

TCTR20230707003 ( http://www.

CLINICALTRIALS

in.th/ ) registered on 28 January 2023.

Association of diastolic blood pressure and coronary artery calcium in South Asian American adults

OBJECTIVE

Diastolic blood pressure (DBP) is associated with atherosclerosis and cardiovascular disease, independent of systolic blood pressure (SBP). However, prior evaluation of the association of DBP with coronary artery calcium (CAC) has not included South Asian adults, a population that is at excess risk of atherosclerotic cardiovascular disease.

METHODS

In the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, we evaluated the association of sex-specific DBP tertiles and CAC score > = 100 with robust Poisson regression adjusted for age, sex, SBP, BP medication use, and other cardiovascular risk factors. We examined these associations stratified by antihypertensive medication use, and secondarily the association of baseline DBP tertile with incident CAC over median 4.7 years of follow-up.

RESULTS

Among 1155 participants (48% women, mean age 57 years), mean (standard deviation) DBP was 74 (10) mmHg, 33% were on antihypertensive medications, and 22% had CAC > = 100. Relative to DBP in tertile 1, DBP in tertiles 2 and 3 was associated with a significantly higher prevalence of CAC > = 100 [adjusted prevalence ratio 1.30 [95% confidence interval (CI) 1.03-1.65] and 1.47 (1.12-1.93), respectively]. These significant associations were primarily observed in participants who were not on antihypertensive medications. Baseline DBP tertile was not associated with incident CAC.

CONCLUSION

Among South Asian adults in MASALA, DBP in the second or third tertiles vs. tertile 1 were associated with a higher prevalence of CAC > = 100 after adjustment for covariates, including SBP. DBP may be an important clinical ASCVD risk factor among South Asian adults.

Threshold effect of non-high-density lipoprotein to high-density lipoprotein cholesterol ratio and hypertension in U.S. adults: NHANES 2005-2016

Hypertension is a prevalent chronic non-communicable disease associated with cardiovascular issues, strokes, kidney disorders, and depression. Most hypertensive patients have dyslipidemia and metabolic abnormalities. The non-high-density lipoprotein to high-density lipoprotein cholesterol ratio (NHHR) is a novel index that more accurately assesses the risk of atherosclerotic cardiovascular diseases and metabolic issues like insulin resistance. The association between NHHR and hypertension prevalence is still unclear. The study aims to examine the link between NHHR and hypertension prevalence in American adults. N10,410 adults from the National Health and Nutrition Examination Survey (NHANES) (2005-2016) were included in this cross-sectional analysis. Multivariable logistic regression constructed to analyze the relationship between NHHR and hypertension, with additional analyses including restricted cubic spline regression (RCS), threshold and saturation effect analyses, effect point calculations, subgroup analyses, and sensitivity analyses. Machine learning methods combined with the Boruta algorithm were employed to identify key predictors of hypertension risk. Of the 10,410 participants, 48% were male, with a hypertension prevalence of 37.03%. NHHR was higher in hypertensive patients compared to non-hypertensive individuals (2.74 vs 2.90, P < .001). In models that were completely confounded with factors including general demographic data, BMI, smoking status, alcohol consumption, diabetes, total cholesterol, history of coronary heart disease, LDL, and dietary cholesterol, NHHR showed a significant positive correlation with hypertension prevalence. RCS regression indicated a non-linear relationship, with a saturation effect point at 3.058. Subgroup analyses showed significant interactions by race and education level (P < .05). Machine learning models demonstrated AUCs > 0.8, affirming the importance of NHHR in predicting hypertension. NHHR levels are significantly elevated in hypertensive individuals compared to non-hypertensive adults in the U.S. Furthermore, a non-linear positive correlation exists between NHHR and hypertension risk, suggesting its potential as a predictive biomarker for early hypertension prevention.

Association between LDL/HDL ratio and hypertension in Chinese middle-aged and older adults: a cross-sectional and longitudinal analysis based on CHARLS LDL/HDL ration and hypertension

Introduction

Hypertension is a global public health issue and major risk factor for cardiovascular disease (CVD). Low-density lipoprotein/high-density lipoprotein ratio (LDL/HDL Ratio, LHR) is an important indicator of lipid metabolism related to CVD. However, the relationship between LHR and the prevalence and incidence of hypertension has not been reported in large populations. This study aims to investigate the association between LHR and hypertension in middle-aged and elderly population.

Methods

This study utilized the China Health and Retirement Longitudinal Study (CHARLS) database from 2011 to 2020. Cross-sectional study was employed to analyze the association between LHR and the prevalence of hypertension; longitudinal analysis was used to examine the association between LHR and the incidence of hypertension. Eligible participants were adults aged 45 years and older with complete LHR and self-reported hypertension records. Multivariate logistic regression, smooth curve fitting, threshold effect analysis was performed.

Results

In the cross-sectional study, we included 13,150 participants. After adjusting for potential confounders, each one-unit increase in LHR was associated with a 22% increase in the prevalence of hypertension (OR = 1.22, 95% CI: 1.15-1.30, P < 0.0001). The association between LHR and hypertension was consistent across different subgroups, with higher LHR being more strongly associated with increased hypertension prevalence in females and non-smokers. Our results revealed a linear relationship between LHR and hypertension prevalence. Longitudinal analysis showed that, among participants without hypertension in 2011, after 7 years of follow-up, the association between LHR and hypertension incidence remained robust after adjusting for a wide range of demographic, clinical, and biochemical variables (P < 0.05).

Conclusions

These results demonstrated significant positive association between LHR and the prevalence & incidence of hypertension, in a nationwide representative middle-aged and elderly population in China.

Circulatory miRNAs in essential hypertension

MicroRNAs (miRNAs) are short non-coding RNAs, that regulate gene-expression at post-transcriptional level. Unlike other RNA species, blood miRNAs circulate in a highly stable form, either within extracellular vesicles or bound to proteins. In recent years, circulatory miRNA profiles have been proposed as potential biomarkers for multitude of pathologies, including essential hypertension. However, the evidence of miRNA biomarker potential is limited, mainly due to the scarcity of profiling studies associating miRNA levels with hypertension. Furthermore, most of these studies have been performed with preselected miRNA pool, limiting their discovery potential. Here, we summarize the results of the unbiased profiling studies and additionally discuss findings from targeted miRNA analysis. Only miR-30e has been found to be associated with hypertension in more than one unbiased study. The targeted analyses highlight the association of miR-1, -21, -34a, -92a, -122, -126, -143, -145, -605, -623, -1299, as well as let-7 and miR-30 families with hypertension. Current literature indicates that some of these miRNAs are involved in hypertension-associated vascular dysfunction and the development of atherosclerosis, suggesting a novel mechanism for cardiovascular disease risk posed by hypertension. All in all, studies associating hypertension with circulatory miRNA profiles are scarce, with several limitations affecting the comparability of the studies. This review discusses the functions and potential mechanisms linking the identified miRNAs to hypertension and underscores the need for further research.

Adrenic acid: A promising biomarker and therapeutic target (Review)

Adrenic acid is a 22‑carbon unsaturated fatty acid that is widely present in the adrenal gland, liver, brain, kidney and vascular system that plays a regulatory role in various pathophysiological processes, such as inflammatory reactions, lipid metabolism, oxidative stress, vascular function, and cell death. Adrenic acid is a potential biomarker for various ailments, including metabolic, neurodegenerative and cardiovascular diseases and cancer. In addition, adrenic acid is influenced by the pharmacological properties of several natural products, such as astragaloside IV, evodiamine, quercetin, kaempferol, Berberine‑baicalin and prebiotics, so it is a promising new target for clinical treatment and drug development. However, the molecular mechanisms by which adrenic acid exerts are unclear. The present study systematically reviewed the biosynthesis and metabolism of adrenic acid, focusing on intrinsic mechanisms that influence the progression of metabolic, cardiovascular and neurological disease. These mechanisms regulate several key processes, including immuno‑inflammatory response, oxidative stress, vascular function and cell death. In addition, the present study explored the potential clinical translational value of adrenic acid as a biomarker and therapeutic target. To the best of our knowledge, the present study is first systematic summary of the mechanisms of action of adrenic acid across a range of diseases. The present study provides understanding of the wide range of metabolic activities of adrenic acid and a basis for further exploring the pathogenesis and therapeutic targets of various diseases.

Jabuticaba (Myrciaria trunciflora) extract improves metabolic and behavioral markers of obese rats fed on a hypercaloric diet

BACKGROUND

Obesity is a metabolic disease that affects many individuals around the world, related to imbalance between energy consumption and expenditure, which can lead to comorbidities. A healthy diet can significantly contribute to the prevention or treatment of this condition. Jabuticaba is an emerging fruit presenting a wide range of bioactive compounds and is being extensively studied due to its effects on lipid metabolism. The aim of this study was to evaluate the jabuticaba extract in the anxious-like behavior and in the lipid and oxidative metabolism in the context of obesity.

METHODS

Forty male Wistar rats divided into five groups were used. The animals received a standard diet and/or a hypercaloric diet and after 60 days of induction, interventions were carried out with jabuticaba extract (5% and 10%) via gavage for 30 days.

RESULTS

It can be observed that the jabuticaba extract was able to reverse the anxious behavior observed in obese animals and modulate parameters of lipid and oxidative metabolism. We observed a reduction in cholesterol and triglyceride levels compared to obese animals. Furthermore, we observed an improvement in oxidative parameters, with a reduction in protein carbonylation in the liver and modulation of antioxidant enzymes such as superoxide dismutase and catalase. Contrary to expectations, we did not observe changes in leptin, adiponectin and tumor necrosis factor alpha (TNF-α) levels.

CONCLUSION

Our work demonstrates that jabuticaba extract can improve metabolic, oxidative and behavioral changes in animals with obesity. © 2024 Society of Chemical Industry.

Diagnostic Utility of Combining Homocysteine, Lipoprotein-Associated Phospholipase A2, and the C-Reactive Protein-to-Albumin Ratio for Assessing Carotid Atherosclerosis and Plaque Stability in Patients with Essential Hypertension

The objective of this study is to determine the diagnostic utility of combining homocysteine (HCY), lipoprotein-associated phospholipase A2 (LP-PLA2), and the C-reactive protein-to-albumin ratio (CAR) for carotid atherosclerosis (CAS) and plaque stability in patients with essential hypertension (EH). A total of 280 patients with EH were divided into 2 groups according to ultrasound diagnosis: CAS (n = 106) and non-CAS (N-CAS [n = 174]). The CAS group was further segmented into plaque-stable (n = 50) and plaque non-stable (n = 56) groups. General data were collected for all patients. Risk factors associated with CAS and plaque instability in patients with EH, and the diagnostic utility of HCY, LP-PLA2, and CAR testing alone, or in combination, for assessing CAS and plaque instability were determined. Mean age, systolic blood pressure (SBP), duration of EH, smoking, total cholesterol high-density lipoprotein cholesterol, HCY, LP-PLA2 levels, and CAR were higher in the CAS group than those in the N-CAS group (P < 0.05). SBP, duration of EH, HCY and LP-PLA2 levels, and CAR were independent risk factors for CAS (P < 0.05). In addition, HCY, LP-PLA2, and CAR alone demonstrated significant diagnostic efficacy (P < 0.001) but were inferior to the combined diagnostic utility of the 3 parameters (P < 0.001). HCY and LP-PLA2 levels, and CAR were higher in the plaque non-stable than in the plaque-stable group (P < 0.05). Duration of EH, low-density lipoprotein cholesterol, HCY, LP-PLA2, and CAR independently influenced plaque instability in patients with CAS (P < 0.05). The combined diagnostic utility of HCY, LP-PLA2, and CAR (P < 0.001) was superior to that of each parameter alone and demonstrated more pronounced diagnostic efficacy (P < 0.001). HCY, LP-PLA2, and CAR were independent risk factors for CAS and plaque instability in patients with EH. HCY, LP-PLA2, and CAR demonstrated significant diagnostic efficacy for CAS and plaque instability, and combination of the 3 demonstrated the most pronounced diagnostic efficacy.

Inhibition of the RXRA-PPARα-FABP4 signaling pathway alleviates vascular cellular aging by an SGLT2 inhibitor in an atherosclerotic mice model

Atherosclerosis is the pathological cause of atherosclerotic cardiovascular disease (ASCVD), which rapidly progresses during the cellular senescence. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce major cardiovascular events in patients with ASCVD and have potential antisenescence effects. Here, we investigate the effects of the SGLT2 inhibitor dapagliflozin on cellular senescence in atherosclerotic mice. Compared with ApoE-/- control mice treated with normal saline, those in the ApoE-/- dapagliflozin group, receiving intragastric dapagliflozin (0.1 mg kg-1 d-1) for 14 weeks, exhibited the reduction in the total aortic plaque area (48.8%±6.6% vs. 74.6%±8.0%, P<0.05), the decrease in the lipid core area ((0.019±0.0037) mm2vs. (0.032±0.0062) mm2, P<0.05) and in the percentage of senescent cells within the plaques (16.4%±3.7% vs. 30.7%±2.0%, P<0.01), while the increase in the thickness of the fibrous cap ((21.6±2.1) µm vs. (14.6±1.5) µm, P<0.01). Transcriptome sequencing of the aortic arch in the mice revealed the involvement of the PPARα and the fatty acid metabolic signaling pathways in dapagliflozin's mechanism of ameliorating cellular aging and plaque progression. In vitro, dapagliflozin inhibited the expression of PPARα and its downstream signal FABP4, by which the accumulation of senescent cells in human aortic smooth muscle cells (HASMCs) was reduced under high-fat conditions. This effect was accompanied by a reduction in the intracellular lipid content and alleviation of oxidative stress. However, these beneficial effects of dapagliflozin could be reversed by the PPARα overexpression. Bioinformatics analysis and molecular docking simulations revealed that dapagliflozin might exert its effects by directly interacting with the RXRA protein, thereby influencing the expression of the PPARα signaling pathway. In conclusion, the cellular senescence of aortic smooth muscle cells is potentially altered by dapagliflozin through the suppression of the RXRA-PPARα-FABP4 signaling pathway, resulting in a deceleration of atherosclerotic progression.

MKI67 with arterial hypertension predict a poor survival for prostate cancer patients, a real-life investigation

INTRODUCTION

Prostate cancer is a common urology malignant in males, ranking second globally. The disease is especially severe when diagnosed alongside hypertension. MKI67 is an established marker of neoplastic cell proliferation in humans, but the significance of its prognostic value in patients with prostate cancer and hypertension requires further research.

METHODS

In this retrospective analysis, we evaluated 296 hypertensive prostate cancer patients between March 2, 2012, and November 1, 2015. We used Cox regression models and prediction analysis to assess overall survival. Furthermore, we created a nomogram and verified its accuracy using a calibration curve.

RESULTS

Of all participants, 101 (34.12%) died. Our multi-factor analysis revealed that MKI67 expression was associated with an increased hazard ratio of death (> fivefold) (Hazard Ratio 5.829, 95% CI 3.349-10.138, p value < 0.01) and progression (twofold) (HR 2.059, 95% CI 1.368-3.102, p value < 0.01). Our Lasso analysis model displayed that several factors, including heart failure, smoking, ACS, serum albumin, Gealson score, prognostic nutritional index, MKI67 expression, surgery, and stage were high risks of prostate cancer. To ensure each covariate's contribution to cancer prognosis, we created a Cox model nomogram, which accurately predicted the risk of death (C-statistic of 0.8289) and had a proper calibration plot for risk assessment.

CONCLUSION

MKI67 expression predicts poor outcomes for overall mortality in prostate cancer and hypertension patients. Additionally, our cross-validated multivariate score, which includes MKI67, demonstrated accuracy efficacy of predicting prognosis.

Functions of TAM Receptors and Ligands Protein S and Gas6 in Atherosclerosis and Cardiovascular Disease

Atherosclerosis and cardiovascular disease are associated with high morbidity and mortality in industrialized nations. The Tyro3, Axl, and Mer (TAM) family of receptor tyrosine kinases is involved in the amplification or resolution of atherosclerosis pathology and other cardiovascular pathology. The ligands of these receptors, Protein S (PS) and growth arrest specific protein 6 (Gas6), are essential for TAM receptor functions in the amplification and resolution of atherosclerosis. The Axl-Gas6 interaction has various effects on cardiovascular disease. Mer and PS dampen inflammation, thereby protecting against atherosclerosis progression. Tyro3, the least studied TAM receptor in cardiovascular disease, appears to protect against fibrosis in post-myocardial infarction injury. Ultimately, PS, Gas6, and TAM receptors present an exciting avenue of potential therapeutic targets against inflammation associated with atherosclerosis and cardiovascular disease.

Effect of Coenzyme Q10 Supplementation on Lipid and Glycaemic Profiles: An Umbrella Review

Coenzyme Q10 (CoQ10) has been suggested as an adjunct therapy for endocrine and metabolic disorders. The aim of this study was to synthesise the evidence for the effect of CoQ10 supplementation on lipid and/or glycaemic alterations, including total cholesterol (TC), LDL- and HDL-cholesterol (LDL-C and HDL-C), lipoprotein a, fasting blood glucose (FBG), haemoglobin A1c (HbA1c), fasting insulin and Homeostatic Model Assessment of Insulin Resistance. A systematic search was conducted in Medline, Scopus, Web of Science and the Cochrane Library from their inception to July 2024. Meta-analyses that evaluated the effect of CoQ10 on the lipid or glycaemic profiles were included. Results were expressed as mean difference (MD) or standardised mean difference (SMD). CoQ10 showed an effect on the glycaemic profile, especially on FBG (MD from -11.21 to -5.2 mg/dL, SMD from -2.04 to -0.17) and on HbA1c (MD from -1.83 to -0.12%, SMD of -0.30). CoQ10 may also have an effect on the lipid profile, such as TC, triglycerides, HDL-C and even LDL-C, although the inconsistency of the results was somewhat higher. Supplementation with CoQ10 may be beneficial, especially in populations with diabetes mellitus or other endocrine and metabolic disorders. It could also have some effect on lipid parameters, which, together with the above, may reduce cardiovascular morbidity and mortality, although this is something that needs further research.

Insulin Resistance Triggers Atherosclerosis: Caveolin 1 Cooperates with PKCzeta to Block Insulin Signaling in Vascular Endothelial Cells

OBJECTIVE

To date, therapies for endothelial dysfunction have primarily focused on ameliorating identified atherosclerosis (AS) risk factors rather than explicitly addressing endothelium-based mechanism. An in-depth exploration of the pathological mechanisms of endothelial injury was performed herein.

METHODS

Aortic caveolin 1 (Cav1) knockdown was achieved in mice using lentivirus, and AS was induced using a high-fat diet. Mouse body weight, blood glucose, insulin, lipid parameters, aortic plaque, endothelial injury, vascular nitric oxide synthase (eNOS), injury marker, and oxidative stress were examined. The effect of Cav1 knockdown on the content of PKCzeta and PI3K/Akt/eNOS pathway-related protein levels, as well as PKCzeta binding to Akt, was studied. ZIP, a PKCzeta inhibitor, was utilized to treat HUVECs in vitro, and the effect of ZIP on cell viability, inflammatory response, oxidative stress, and Akt activation was evaluated.

RESULTS

Cav1 knockdown had no significant effect on body weight or blood glucose in mice over an 8-week period, whereas drastically reduced insulin, lipid parameters, endothelial damage, E-selectin, and oxidative stress and elevated eNOS levels. Moreover, Cav1 knockdown triggered decreased PKCzeta enrichment and the activation of the PI3K/Akt/eNOS pathway. PKCzeta has a positive effect on cells without being coupled by Cav1, and ZIP had no marked influence on PKCzeta-Akt binding following Cav1/PKCzeta coupling.

CONCLUSION

Cav1/PKCzeta coupling antagonizes the activation of PI3K on Akt, leading to eNOS dysfunction, insulin resistance, and endothelial cell damage.

Low or oscillatory shear stress and endothelial permeability in atherosclerosis

Endothelial shear stress is a tangential stress derived from the friction of the flowing blood on the endothelial surface of the arterial wall and is expressed in units of force/unit area (dyne/cm2). Branches and bends of arteries are exposed to complex blood flow patterns that generate low or oscillatory endothelial shear stress, which impairs glycocalyx integrity, cytoskeleton arrangement and endothelial junctions (adherens junctions, tight junctions, gap junctions), thus increasing endothelial permeability. The lipoproteins and inflammatory cells penetrating intima due to the increased endothelial permeability characterizes the pathological changes in early stage of atherosclerosis. Endothelial cells are critical sensors of shear stress, however, the mechanisms by which the complex shear stress regulate endothelial permeability in atherosclerosis remain unclear. In this review, we focus on the molecular mechanisms of the endothelial permeability induced by low or oscillatory shear stress, which will shed a novel sight in early stage of atherosclerosis.

Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and hypertension in American adults: a NHANES cross-sectional study

Objectives

The relationship between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and hypertension remains uncertain, warranting further investigation. This study aims to elucidate the association between NHHR and hypertension.

Methods

A comprehensive cross-sectional stratified survey involving 30,602 participants aged 20 years and older was conducted using the National Health and Nutrition Examination Survey (NHANES) dataset from 2001 to 2018. NHHR was calculated as [total cholesterol (TC) - high-density lipoprotein cholesterol (HDL-C)]/HDL-C. The relationship between NHHR and hypertension was examined using weighted multiple linear regression, smooth curve fitting, hierarchical analysis, and interaction testing.

Results

The mean age of participants was 49.82 ± 17.64 years, with 15,266 women included. The average NHHR was 2.94 ± 0.56. A positive correlation between NHHR and hypertension was observed. Stratification of NHHR into quartiles, in the fully adjusted Model 3, revealed that individuals in the highest NHHR quartile had a 60% increased risk of hypertension for each unit increase in NHHR compared to those in the lowest quartile. Interaction tests indicated that the relationship between NHHR and hypertension remained consistent across subgroups, except for gender, age, education, and smoking status, which influenced this association.

Conclusion

Analysis of NHANES data from 2001 to 2018 demonstrated a consistent positive association between NHHR and hypertension. NHHR may provide potential assistance in hypertension prevention and diagnosis.

Cellular metabolism changes in atherosclerosis and the impact of comorbidities

Cell activation and nutrient dysregulation are common consequences of atherosclerosis and its preceding risk factors, such as hypertension, dyslipidemia, and diabetes. These diseases may also impact cellular metabolism and consequently cell function, and the other way around, altered cellular metabolism can impact disease development and progression through altered cell function. Understanding the contribution of altered cellular metabolism to atherosclerosis and how cellular metabolism may be altered by co-morbidities and atherosclerosis risk factors could support the development of novel strategies to lower the risk of CVD. Therefore, we briefly review disease pathogenesis and the principles of cell metabolic pathways, before detailing changes in cellular metabolism in the context of atherosclerosis and comorbidities. In the hypoxic, inflammatory and hyperlipidemic milieu of the atherosclerotic plaque riddled with oxidative stress, metabolism shifts to increase anaerobic glycolysis, the pentose-phosphate pathway and amino acid use. We elaborate on metabolic changes for macrophages, neutrophils, vascular endothelial cells, vascular smooth muscle cells and lymphocytes in the context of atherosclerosis and its co-morbidities hypertension, dyslipidemia, and diabetes. Since causal relationships of specific key genes in a metabolic pathway can be cell type-specific and comorbidity-dependent, the impact of cell-specific metabolic changes must be thoroughly explored in vivo, with a focus on also systemic effects. When cell-specific treatments become feasible, this information will be crucial for determining the best metabolic intervention to improve atherosclerosis and its interplay with co-morbidities.

Cardioprotective Effects of Aloysia polystachya Essential Oil on a Rat Model with Multiple Cardiovascular Risk Factors

Traditional medicine is a frequently utilized method to treat cardiovascular disease and its primary risk factors, including hypertension and dyslipidemia. Aloysia polystachya is a species that is commonly employed to treat various pathological conditions, and it has already been identified as having some cardioprotective effects. This study aimed to investigate the protective effects of the essential oil extracted from the leaves of A. polystachya in a rat model that simulates multiple cardiovascular risk factors. We evaluate the acute toxicity, as well as the cardioprotective effects, by giving different doses of A. polystachya essential oil (1.47 mg/kg, 4.40 mg/kg, and 13.20 mg/kg) over a period of 42 days. The control group was treated with rosuvastatin (5 mg/kg). At the end of the treatments, the renal function, electrocardiography, blood pressure, vascular reactivity, serum biochemical profile, and organ histopathology were evaluated. The main compounds identified in the essential oil of A. polystachya using gas chromatography coupled with mass spectrometry were beta-myrcene (1.08%), limonene (40.13%), and carvone (56.47%). The essential oil of A. polystachya not only lacks acute toxicity but also mitigates the reduction in the excretion of sodium, chloride, and creatinine in urine. Furthermore, it reduces electrocardiographic abnormalities and decreases blood pressure levels. Moreover, this treatment prevents an elevation in markers of inflammation and oxidative stress in the bloodstream. Our findings indicate significant cardioprotective effects of the essential oil of A. polystachya against multiple risk factors for cardiovascular diseases in hypertensive rats.

Pro-atherogenic medical conditions are associated with widespread regional brain metabolite abnormalities in those with alcohol use disorder

AIMS

Widespread brain metabolite abnormalities in those with alcohol use disorder (AUD) were reported in numerous studies, but the effects of the pro-atherogenic conditions of hypertension, type 2 diabetes mellitus, hepatitis C seropositivity, and hyperlipidemia on metabolite levels were not considered. These conditions were associated with brain metabolite abnormalities in those without AUD. We predicted treatment-seeking individuals with AUD and pro-atherogenic conditions (Atherogenic+) demonstrate lower regional metabolite markers of neuronal viability [N-acetylaspartate (NAA)] and cell membrane turnover/synthesis [choline-containing compounds (Cho)], compared with those with AUD without pro-atherogenic conditions (Atherogenic-) and healthy controls (CON).

METHODS

Atherogenic+ (n = 59) and Atherogenic- (n = 51) and CON (n = 49) completed a 1.5 T proton magnetic resonance spectroscopic imaging study. Groups were compared on NAA, Cho, total creatine, and myoinositol in cortical gray matter (GM), white matter (WM), and select subcortical regions.

RESULTS

Atherogenic+ had lower frontal GM and temporal WM NAA than CON. Atherogenic+ showed lower parietal GM, frontal, parietal and occipital WM and lenticular nuclei NAA level than Atherogenic- and CON. Atherogenic- showed lower frontal GM and WM NAA than CON. Atherogenic+ had lower Cho level than CON in the frontal GM, parietal WM, and thalamus. Atherogenic+ showed lower frontal WM and cerebellar vermis Cho than Atherogenic- and CON.

CONCLUSIONS

Findings suggest proatherogenic conditions in those with AUD were associated with increased compromise of neuronal integrity and cell membrane turnover/synthesis. The greater metabolite abnormalities observed in Atherogenic+ may relate to increased oxidative stress-related compromise of neuronal and glial cell structure and/or impaired arterial vasoreactivity/lumen viability.

Vitamin D and Atherosclerosis: Unraveling the Impact on Macrophage Function

Vitamin D plays a crucial role in preventing atherosclerosis and in the regulation of macrophage function. This review aims to provide a comprehensive summary of the clinical evidence regarding the impact of vitamin D on atherosclerotic cardiovascular disease, atherosclerotic cerebrovascular disease, peripheral arterial disease, and associated risk factors. Additionally, it explores the mechanistic studies investigating the influence of vitamin D on macrophage function in atherosclerosis. Numerous findings indicate that vitamin D inhibits monocyte or macrophage recruitment, macrophage cholesterol uptake, and esterification. Moreover, it induces autophagy of lipid droplets in macrophages, promotes cholesterol efflux from macrophages, and regulates macrophage polarization. This review particularly focuses on analyzing the molecular mechanisms and signaling pathways through which vitamin D modulates macrophage function in atherosclerosis. It claims that vitamin D has a direct inhibitory effect on the formation, adhesion, and migration of lipid-loaded monocytes, thus exerting anti-atherosclerotic effects. Therefore, this review emphasizes the crucial role of vitamin D in regulating macrophage function and preventing the development of atherosclerosis.

Dietary intake of plant polyphenols: Exploring trend in the Czech population

OBJECTIVES

This study aimed to determine trend in polyphenol consumption in the Czech Republic during the last three decades. Additionally, it provides a brief overview of the beneficial effects of polyphenols in several body systems.

METHODS

Data from the Phenol-Explorer 3.6, a specialized database of polyphenolic substances, were assigned to the resources of the Czech Statistical Office on the consumption of food and beverages in the Czech Republic for the years 1989-2022. The average daily intake of polyphenols was determined by multiplying the average annual consumption of each type of food by the polyphenol content obtained from the database; results were given in milligrams of polyphenols per inhabitant and day. Since the food items in the data sources are not identical, it was necessary to create an extensive model of food categories.

RESULTS

The current value of polyphenol intake is 1,673 mg per day per inhabitant; however, this level most likely reflects methodological underestimation. The favourable increase in dietary polyphenol intake in the Czech population - doubling, to be precise - which we observed from 1989 to 2007, has been replaced by the opposite trend in the last 15 years. The current intake of polyphenols corresponds to the level that was already achieved in 2004. Hydroxycinnamic acids (from the group of phenolic acids) are the most prevalent dietary polyphenols, followed by flavanols (from the group of flavonoids). The most frequent source of polyphenols in the Czech population are non-alcoholic beverages such as coffee, tea and juices, followed by fruits, cereals, and vegetables, respectively.

CONCLUSION

Current trend of dietary polyphenol intake in the Czech population is slightly decreasing. This tendency, lasting since 2008, is indisputably negative. Plant polyphenols offer opportunities for inexpensive interventions in health promotion.

Analysis of the Associations of Measurements of Body Composition and Inflammatory Factors with Cardiovascular Disease and Its Comorbidities in a Community-Based Study

The associations of cardiovascular disease (CVD) with comorbidities and biochemical and body composition measurements are repeatedly described but have not been studied simultaneously. In the present cross-sectional study, information on CVD and comorbidities [type 2 diabetes mellitus (T2DM), hypertension (HTN), and hyperlipidemia (HDL)], body composition, levels of soluble markers, and other measures were collected from 1079 individuals. When we examined the association of each comorbidity and CVD, controlling for other comorbidities, we observed a clear pattern of the comorbidity-related specific associations with tested covariates. For example, T2DM was significantly associated with GDF-15 levels and the leptin/adiponectin (L/A) ratio independently of two other comorbidities; HTN, similarly, was independently associated with extracellular water (ECW) levels, L/A ratio, and age; and HDL was independently related to age only. CVD showed very strong independent associations with each of the comorbidities, being associated most strongly with HTN (OR = 10.89, 6.46-18.38) but also with HDL (2.49, 1.43-4.33) and T2DM (1.93, 1.12-3.33). An additive Bayesian network analysis suggests that all three comorbidities, particularly HTN, GDF-15 levels, and ECW content, likely have a main role in the risk of CVD development. Other factors, L/A ratio, lymphocyte count, and the systemic inflammation response index, are likely indirectly related to CVD, acting through the comorbidities and ECW.

Coenzyme Q10 in atherosclerosis

Atherosclerotic disease is a chronic disease that predominantly affects the elderly and is the most common cause of cardiovascular death worldwide. Atherosclerosis is closely related to processes such as abnormal lipid transport and metabolism, impaired endothelial function, inflammation, and oxidative stress. Coenzyme Q10 (CoQ10) is a key component of complex Ⅰ in the electron transport chain and an important endogenous antioxidant that may play a role in decelerating the progression of atherosclerosis. Here, the different forms of CoQ10 presence in the electron transport chain are reviewed, as well as its physiological role in regulating processes such as oxidative stress, inflammatory response, lipid metabolism and cellular autophagy. It was also found that CoQ10 plays beneficial effects in atherosclerosis by mitigating lipid transportation, endothelial inflammation, metabolic abnormalities, and thrombotic processes from the perspectives of molecular mechanisms, animal experiments, and clinical evidence. Besides, the combined use of CoQ10 with other drugs has better synergistic therapeutic effects. It seems reasonable to suggest that CoQ10 could be used in the treatment of atherosclerotic cardiovascular diseases while more basic and clinical studies are needed.

Pathological Findings of Donor Vessels in Bypass Surgery

(1) Background Cerebral revascularization is necessary to treat intracranial arterial stenosis caused by moyamoya disease, atherosclerosis, or large complex aneurysms. Although various donor vascular harvesting methods have been reported safe, there are no reports on the histological evaluation of donor vessels for each disease, despite the variety of diseases wherein vascular anastomosis is required. (2) Methods Pathological findings of the superficial temporal artery (STA), radial artery (RA), occipital artery (OA), and saphenous vein (SV) harvested at the institution were analyzed. Patients classified according to aneurysm, atherosclerosis, and moyamoya disease were assessed for pathological abnormalities, medical history, age, sex, smoking, and postoperative anastomosis patency. (3) Results There were 38 cases of atherosclerosis, 15 cases of moyamoya disease, and 30 cases of aneurysm in 98 donor vessels (mean age 57.2) taken after 2006. Of the 84 STA, 11 RA, 2 OA, and 1 SV arteries that were harvested, 71.4% had atherosclerosis, 11.2% had dissection, and 10.2% had inflammation. There was no significant difference in the proportion of pathological findings according to the disease. A history of hypertension is associated with atherosclerosis in donor vessels. (4) Conclusions This is the first study to histologically evaluate the pathological findings of donor vessels according to disease. The proportion of dissection findings indicative of vascular damage due to surgical manipulation was not statistically different between the different conditions.

The impact of dyslipidemia on prognosis of patients after endovascular abdominal aortic aneurysm repair

Introduction

Dyslipidemia is common in patients with abdominal aortic aneurysm (AAA). However, there is insufficient research on the impact of dyslipidemia on the postoperative outcomes of patients with AAA after endovascular aortic aneurysm repair (EVAR). This study aimed to determine the impact of dyslipidemia on the prognosis of patients with AAA treated with EVAR.

Method

We retrospectively reviewed patients with AAA who underwent EVAR at our hospital between 2010 and 2020. The baseline characteristics and prognoses of patients in the dyslipidemia and non-dyslipidemia groups were analyzed.

Results

A total of 641 patients were included; the prevalence of dyslipidemia in patients with AAA was 42.3% (271/641), and the mean follow-up time was 63.37 ± 26.49 months. The prevalence of diabetes (10.0% vs. 15.1%, P = 0.050), peripheral arterial disease (17.3% vs. 25.8%, P = 0.018), and chronic kidney disease (3.0% vs. 6.3%, P = 0.043) was higher in the dyslipidemia group. The three-year all-cause mortality rate after EVAR was 9.98% (64/641), and there was no difference in the incidence of all-cause mortality (10.27% vs. 9.59%, P = 0.778) between the two groups. A total of 36 (5.62%) major adverse cardiovascular and cerebrovascular events (MACCEs) were observed within 3 years and were more common in patients with dyslipidemia (2.97% vs. 9.59%, P < 0.001). The incidence of stent-related complications in all patients was 19.97% (128/641), and there was no difference in the incidence of stent-related complications between the two groups (22.16% vs. 16.97%, P = 0.105); however, the incidence of type I endoleak in the dyslipidemia group was lower than that in the non-dyslipidemia group (9.19% vs. 4.06%, P = 0.012). Cox-regression analysis showed that high level of high-density lipoprotein cholesterol (HDL-C) was the protective factor (HR, 0.203, 95% CI, 0.067-0.616, P = 0.005) for MACCES, but it was the risk factor for type I endoleak (HR, 2.317, 95% CI, 1.202-4.466, P = 0.012).

Conclusion

Dyslipidemia did not affect the mortality of patients with AAA who underwent EVAR; however, it may increase the incidence of MACCEs. Dyslipidemia may decrease the incidence of type I endoleaks after EVAR; however, further studies are warranted. We should strengthen the postoperative management of patients with dyslipidemia, prevent the occurrence of MACCEs.

Resistance Training in Cardiovascular Diseases: A Review on Its Effectiveness in Controlling Risk Factors

Cardiovascular Disease (CVD), a term encompassing various disorders affecting the heart and blood vessels, includes coronary artery disease (CAD). CAD is primarily due to the development of atherosclerotic plaques that disrupt blood flow, oxygenation, and nutrient delivery to the myocardium. Risk factors contributing to CAD progression include smoking, hypertension, diabetes mellitus (DM), dyslipidaemia, and obesity. While aerobic exercise (AE) has shown promising results in controlling CVD risk factors, the impact of resistance training (RT) has not been extensively investigated. This review aims to describe the effects of RT on CVD risk factors based on studies retrieved from PubMed and Google Scholar databases. Both isometric and isotonic RT have been found to decrease systolic blood pressure (SBP), diastolic blood pressure, or mean arterial pressure, with SBP showing a more significant reduction. Hypertensive patients engaging in RT alongside a calorie-restricted diet demonstrated significant improvements in blood pressure. RT is associated with increased nitric oxide bioavailability, sympathetic modulation, and enhanced endothelial function. In type-2 DM patients, 8-12 weeks of RT led to improvements in fasting blood glucose levels, insulin secretion, metabolic syndrome risk, and glucose transporter numbers. Combining AE with RT had a more significant impact in reducing insulin resistance and enhancing blood glucose compared to performing exercises separately. It also significantly decreased total cholesterol, triglycerides, and low-density lipoprotein levels while increasing high-density lipoprotein within 12 weeks of application. However, improvements are considered insignificant when lipid levels are already low to normal at baseline. The administration of RT resulted in weight loss and improved body mass index, with more pronounced effects seen when combining AE with RT and a calorie-restricted diet. Considering these results, the administration of RT, either alone or in combination with AE, proves beneficial in rehabilitating CAD patients by improving various risk factors.

Prevalence and Associated Factors of Atherosclerotic Plaque and Stenosis in Renal Arteries: A Community-Based Study

The epidemiology of renal artery atherosclerosis in community populations is poorly documented. This study aimed to determine the prevalence of renal artery plaque (RAP) and atherosclerotic renal artery stenosis (ARAS), and the association of plaque and stenosis with vascular risk factors and kidney disease markers among community-dwelling adults. We conducted a cross-sectional analysis of the Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE) study. RAP and ARAS were evaluated by thoracoabdominal computed tomography angiography. A total of 3045 adults aged 50-75 years were included. The prevalence of RAP and ARAS was 28.7% and 4.8%, respectively. The prevalence of RAP and ARAS was 41.3% and 7.7% in individuals aged ≥60 years, 42.9% and 8.7% in hypertensives, and 45.4% and 8.5% in individuals with chronic kidney disease. Older age, hypertension, higher total cholesterol level, and lower high-density lipoprotein cholesterol level were independently associated with RAP and ARAS. A higher urinary albumin-creatinine ratio was independently associated with RAP, whereas a reduced estimated glomerular filtration rate was independently associated with ARAS. In conclusion, there was a non-negligible prevalence of RAP and ARAS among the older, community population in China.

Efficacy and safety of combination therapy with telmisartan, rosuvastatin, and ezetimibe in patients with dyslipidemia and hypertension: A randomized, double-blind, multicenter, therapeutic confirmatory, phase III clinical trial

This study aimed to compare and evaluate the efficacy of the blood pressure (BP) control and cholesterol-lowering effects and safety of combination therapy with telmisartan, rosuvastatin, and ezetimibe versus rosuvastatin and ezetimibe double therapy or telmisartan single therapy in dyslipidemia patients with hypertension. After a wash-out/therapeutic lifestyle change period of ≥4 weeks, a total of 100 eligible patients were randomized and received one of three treatments for 8 weeks: (1) telmisartan 80 mg/rosuvastatin 20 mg/ezetimibe 10 mg (TRE), (2) rosuvastatin 20 mg/ezetimibe 10 mg (RE), or (3) telmisartan 80 mg (T). The primary endpoint was the efficacy evaluation of TRE by comparing changes in mean sitting systolic blood pressure (msSBP) and mean percentage change in low-density lipoprotein-C (LDL-C) from baseline after 8 weeks of treatment. The least square (LS) mean (SE) changes in msSBP at 8 weeks compared with baseline were -23.02 (3.04) versus -7.18 (3.09) mmHg in the TRE and RE groups, respectively (p < .0001), and -25.80 (2.74) versus -14.92 (2.65) mmHg in the TRE and T groups, respectively (p = .0005). The percentage changes in the mean (SD) LDL-C at 8 weeks compared with baseline were -54.97% (3.49%) versus -0.17% (3.23%) in the TRE and T groups, respectively (p < .0001). No serious adverse events occurred, and no statistically significant differences in the incidence of overall AEs and adverse drug reactions occurred among the three groups. TRE therapy significantly decreased msSBP and LDL-C compared to RE or T therapy with comparable safety and tolerability profiles.

Long-term pulmonary iron oxide nanoparticles exposure disrupts hepatic iron-lipid homeostasis and increases plaque vulnerability in ApoE-/- mice

Iron oxide nanoparticles (Fe3O4 NPs) have attracted great attention due to their extensive applications, which warranted their environmental concerns. Although recent advances have proposed the relevance of Fe3O4 NPs to cardiovascular disease, the intrinsic mechanisms underlying the effects of NPs remain indistinct. ApoE-/- mice were chosen as a long-term exposure model to explore the immanent association between respiratory exposure to Fe3O4 NPs and the development of cardiovascular diseases. Pulmonary exposure to 20 nm and 200 nm Fe3O4 NPS resulted in significant lung injury, and pulmonary histopathological examination displayed inflammatory cell infiltration, septal thickening and alveolar congestion. Intriguingly, liver iron deposition and variations in the hepatic lipid homeostasis were found in Fe3O4 NPs-exposed mice, eventually leading to dyslipidemia, hinting the potential cardiovascular toxicity of Fe3O4 NPs. In addition, we not only found that Fe3O4 NPs exposure increased aortic plaque area, but also increased M1 macrophages in the plaque, which yielding plaque vulnerability in ApoE-/- mice Of note, 20 nm Fe3O4 NPs showed enhanced capability on the progression of atherosclerosis than 200 nm Fe3O4 NPs. This study may propose the potential mechanism for adverse cardiovascular disease induced by Fe3O4 NPs and provide convincing evidence for the safety evaluation of Fe3O4 NPs.

The association between dyslipidaemia in the first trimester and adverse pregnancy outcomes in pregnant women with subclinical hypothyroidism: a cohort study

BACKGROUND

Subclinical hypothyroidism (SCH) is linked to dyslipidaemia and adverse pregnancy outcomes. However, the impact of dyslipidaemia on the outcome of pregnancy in SCH is unclear.

METHODS

We enrolled 36,256 pregnant women and evaluated their pregnancy outcomes. The following data was gathered during the first trimester (≤ 13+ 6 weeks of gestation): total cholesterol (TC), low-density lipoprotein (LDL-C), triglyceride (TG), high-density lipoprotein (HDL-C), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) concentrations. The reference ranges for lipids were estimated to range from the 5th to the 95th percentile. Logistic regression assessed the relationships between dyslipidaemia and adverse pregnancy outcomes, including abortion, preeclampsia/eclampsia, low birth weight, foetal growth restriction, premature rupture of foetal membranes, gestational hypertension, preterm birth, macrosomia and gestational diabetes mellitus (GDM). Additionally, the best thresholds for predicting adverse pregnancy outcomes based on TSH, FT4, and lipid levels were determined using receiver operating characteristic curves.

RESULTS

In the first trimester, LDL-C > 3.24 mmol/L, TG > 1.92 mmol/L, HDL-C < 1.06 mmol/L, and TC > 5.39 mmol/L were used to define dyslipidaemia. In this cohort, 952 (3.56%) patients were diagnosed with SCH, and those who had dyslipidaemia in the first trimester had higher incidences of gestational hypertension (6.59% vs. 3.25%), preeclampsia/eclampsia (7.14% vs. 3.12%), GDM (22.53% vs. 13.77%), and low birth weight (4.95% vs. 2.08%) than did those without dyslipidaemia. However, after adjusting for prepregnancy body mass index (pre-BMI), dyslipidaemia was no longer related to these risks. Furthermore, elevated TG dyslipidaemia in SCH patients was connected to an enhanced potential of gestational hypertension (odds ratio [OR]: 2.687, 95% confidence interval [CI]: 1.074 ~ 6.722), and elevated LDL-C dyslipidaemia correlated with increased preeclampsia/eclampsia risk (OR: 3.172, 95% CI: 1.204 ~ 8.355) after accounting for age, smoking status, alcohol use, pre-BMI, and levothyroxine use. Additionally, the combination of TC, TG, LDL-C, pre-BMI, and TSH exhibited enhanced predictive capabilities for gestational hypertension, preeclampsia/eclampsia, and GDM. Values of 0.767, 0.704, and 0.706 were obtained from the area under the curve.

CONCLUSIONS

Among pregnant women with SCH, dyslipidaemia in early pregnancy was related to elevated risks of adverse pregnancy consequences. The combined consideration of age, pre-BMI, TSH, and lipid levels in the first trimester could be beneficial for monitoring patients and implementing interventions to reduce adverse pregnancy outcomes.

Lifestyle and clinical factors as predictive indicators of cardiometabolic multimorbidity in Chinese adults: Baseline findings of the Beijing Health Management Cohort (BHMC) study

BACKGROUND

Cardiometabolic multimorbidity (CMM) is increasing globally as a result of lifestyle changes and the aging population. Even though previous studies have examined risk factors associated with CMM, there is a shortage of prediction models that can accurately identify high-risk individuals for early prevention.

METHODS

In the baseline survey of the Beijing Health Management Cohort, a total of 77,752 adults aged 18 years or older were recruited from 2020 to 2021. Data on lifestyle factors, clinical profiles, and diagnoses of diabetes, coronary heart disease, and stroke were collected. Logistic regression models were used to identify risk factors for CMM. Nomograms were developed to estimate an individual's probability of CMM based on the identified risk factors. The performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC).

RESULTS

In men, the top three risk factors for CMM were hypertension (OR: 3.52, 95 % CI: 2.97-4.18), eating very fast (3.43, 2.27-5.16), and dyslipidemia (2.59, 2.20-3.06). In women, hypertension showed the strongest association with CMM (3.62, 2.90-4.52), followed by night sleep duration less than 5 h per day (2.41, 1.67-3.50) and dyslipidemia (1.91, 1.58-2.32). The ORs for holding passive and depressed psychological traits were 1.49 (95%CI: 1.08-2.06) in men and 1.58 (1.03-2.43) in women. Prediction models incorporating these factors demonstrated good discrimination in the test set, with AUC 0.84 (0.83-0.86) for men and 0.90 (0.89-0.91) for women. The sex-specific nomograms were established based on selected predictors.

CONCLUSIONS

Modifiable lifestyle factors, metabolic health and psychological trait are associated with the risk of CMM. The developed prediction models and nomograms could facilitate early identification of individuals at high-risk of CMM.

Purification, structural characteristics and anti-atherosclerosis activity of a novel green tea polysaccharide

A new homogeneous polysaccharide (TPS3A) was isolated and purified from Tianzhu Xianyue fried green tea by DEAE-52 cellulose and Sephacryl S-500 column chromatography. Structural characterization indicated that TPS3A mainly consisted of arabinose, galactose, galacturonic acid and rhamnose in a molar ratio of 5.84: 4.15: 2.06: 1, with an average molecular weight of 1.596 × 104 kDa. The structure of TPS3A was characterized as a repeating unit consisting of 1,3-Galp, 1,4-Galp, 1,3,6-Galp, 1,3-Araf, 1,5-Araf, 1,2,4-Rhap and 1-GalpA, with two branches on the C6 of 1,3,6-Galp and C2 of 1,2,4-Rhap, respectively. To investigate the preventive effects of TPS3A on atherosclerosis, TPS3A was administered orally to ApoE-deficient (ApoE-/-) mice. Results revealed that TPS3A intervention could effectively delay the atherosclerotic plaque progression, modulate dyslipidemia, and reduce the transformation of vascular smooth muscle cells (VSMCs) from contractile phenotype to synthetic phenotype by activating the expression of contractile marker alpha-smooth muscle actin (α-SMA) and inhibiting the expression of synthetic marker osteopontin (OPN) in high-fat diet-induced ApoE-/- mice. Our findings suggested that TPS3A markedly alleviated atherosclerosis by regulating dyslipidemia and phenotypic transition of VSMCs, and might be used as a novel functional ingredient to promote cardiovascular health.

Cardiometabolic Risk Factors Associated With Type 2 Diabetes Mellitus: A Mechanistic Insight

A complex metabolic condition referred to as Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR) and decreased insulin production. Obesity, dyslipidemia, hypertension, and chronic inflammation are just a few of the cardiometabolic illnesses that people with T2DM are more likely to acquire and results in cardiovascular issues. It is essential to comprehend the mechanistic insights into these risk variables in order to prevent and manage cardiovascular problems in T2DM effectively. Impaired glycemic control leads to upregulation of De novo lipogenesis (DNL), promote hepatic triglyceride (TG) synthesis, worsening dyslipidemia that is accompanied by low levels of high density lipoprotein cholesterol (HDL-C) and high amounts of small, dense low-density lipoprotein cholesterol (LDL-C) further developing atherosclerosis. By causing endothelial dysfunction, oxidative stress, and chronic inflammation, chronic hyperglycemia worsens already existing cardiometabolic risk factors. Vasoconstriction, inflammation, and platelet aggregation are caused by endothelial dysfunction, which is characterized by decreased nitric oxide production, increased release of vasoconstrictors, proinflammatory cytokines, and adhesion molecules. The loop of IR and endothelial dysfunction is sustained by chronic inflammation fueled by inflammatory mediators produced in adipose tissue. Infiltrating inflammatory cells exacerbate inflammation and the development of plaque in the artery wall. In addition, the combination of chronic inflammation, dyslipidemia, and IR contributes to the emergence of hypertension, a prevalent comorbidity in T2DM. The ability to target therapies and management techniques is made possible by improvements in our knowledge of these mechanistic insights. Aim of present review is to enhance our current understanding of the mechanistic insights into the cardiometabolic risk factors related to T2DM provides important details into the interaction of pathophysiological processes resulting in cardiovascular problems. Understanding these pathways will enable us to create efficient plans for the prevention, detection, and treatment of cardiovascular problems in T2DM patients, ultimately leading to better overall health outcomes.

Comparison and Evaluation of Two Combination Modes of Angiotensin for Establishing Murine Aortic Dissection Models

Aortic dissection (AD) is a potentially fatal cardiovascular emergency caused by separation of different layers of aortic wall. However, because of limited time window available for clinical research, there is an urgent need for an ideal animal research model. In recent years, the incidence of AD complicated by atherosclerosis has increased with improvements of living standards and changes of eating habits. Accordingly, considering multiple risk factors, we successfully and efficiently established a novel AD model through a high-fat diet combined with chronic angiotensin II (AngII) infusion. Compared with traditional chemical induction model using AngII and β-aminopropionitrile, our model is more clinically relevant for atherosclerosis-related AD. Moreover, infiltration of neutrophils and apoptosis of vascular smooth muscle cells in AD tissues were more significant. In addition to enriching the existing models, the novel model may be a long-term useful tool for more in-depth investigation of AD mechanisms and preclinical therapeutic developments.

AhR, PXR and CAR: From Xenobiotic Receptors to Metabolic Sensors

Traditionally, xenobiotic receptors are known for their role in chemical sensing and detoxification, as receptor activation regulates the expression of various key enzymes and receptors. However, recent studies have highlighted that xenobiotic receptors also play a key role in the regulation of lipid metabolism and therefore function also as metabolic sensors. Since dyslipidemia is a major risk factor for various cardiometabolic diseases, like atherosclerosis and non-alcoholic fatty liver disease, it is of major importance to understand the molecular mechanisms that are regulated by xenobiotic receptors. In this review, three major xenobiotic receptors will be discussed, being the aryl hydrocarbon receptor (AhR), pregnane X receptor (PXR) and the constitutive androstane receptor (CAR). Specifically, this review will focus on recent insights into the metabolic functions of these receptors, especially in the field of lipid metabolism and the associated dyslipidemia.

Prevalence and factors associated with carotid atherosclerosis in a Malagasy population with Type 2 diabetes mellitus: A cross-sectional retrospective study

AIM

Our study aims to determine the prevalence and factors associated with carotid atherosclerosis in Malagasy Type 2 diabetes mellitus (T2DM).

METHODS

This was a cross-sectional retrospective study, carried out over a period of 30 months. The diagnosis of carotid atherosclerosis is established by the presence of a carotid plaque increased carotid intima-media thickness ≥1.1 mm on Doppler ultrasound.

RESULTS

We included 132 T2DM. The prevalence of carotid atherosclerosis was 63.6% (38.6% carotid plaque and 25% intima-media thickening). After univariate analysis, the factors associated with carotid atherosclerosis were age ≥70 years (3.28 [1.18-10, 62]), previous intake of oral antidiabetics (0.33 [0.14-0.73]), insulin (0.28 [0.11-0.66]) and angiotensin receptor blocker (0.45 [0.20-0.98]), and current smoking (5.93 [1.64-32.6]). After adjustment for age and gender, previous intake of oral antidiabetics (0.29 [0.13-0.64]), insulin (0.27 [0.12-0.61]) and angiotensin receptor blocker (0.40 [0.19-0.86]), and current smoking (5.98 [1.61-22.1]) were associated with carotid atherosclerosis.

CONCLUSION

Smoking cessation, education on therapeutic compliance and comprehensive management of all cardiovascular risk factors and T2DM are therefore essential in order to reduce the occurrence of carotid atherosclerosis.

SGLT2 Inhibitors in Aging-Related Cardiovascular Disease: A Review of Potential Mechanisms

Population aging combined with higher susceptibility to cardiovascular diseases in older adults is increasing the incidence of conditions such as atherosclerosis, myocardial infarction, heart failure, myocardial hypertrophy, myocardial fibrosis, arrhythmia, and hypertension. sodium-glucose cotransporter 2 inhibitors (SGLT2i) were originally developed as a novel oral drug for patients with type 2 diabetes mellitus. Unexpectedly, recent studies have shown that, beyond their effect on hyperglycemia, SGLT2i also have a variety of beneficial effects on cardiovascular disease. Experimental models of cardiovascular disease have shown that SGLT2i ameliorate the process of aging-related cardiovascular disease by inhibiting inflammation, reducing oxidative stress, and reversing endothelial dysfunction. In this review, we discuss the role of SGLT2i in aging-related cardiovascular disease and propose the use of SGLT2i to prevent and treat these conditions in older adults.

Screening and clinical characteristics analysis of familial hypercholesterolemia in a tertiary public hospital

Background and aims

Familial hypercholesterolemia (FH) is becoming a global burden. However, it remains underdiagnosed and undertreated worldwide. This study aimed to observe the screening rate of FH patients and department distribution among hospitalized patients using different diagnostic criteria.

Methods

A total of 45,410 inpatients with LDL-C ≥3.5 mmol/L between 2008 and 2019 were included from The Second Affiliated Hospital of Nanchang University. Inpatients are diagnosed and divided into groups by Dutch Lipid Clinic Network (DLCN) criteria, Chinese-modified DLCN criteria and Chinese expert consensus (CEC) criteria.

Results

There were 172, 1,076 and 115 inpatients included in the DLCN group, Chinese-modified DLCN group and CEC group, respectively (screening rates: 0.38%, 2.37% and 0.25%). These FH patients had a very high risk of atherosclerotic cardiovascular disease (ASCVD) (55.7%-74.4%), especially in the DLCN group and CEC group (70.4%-74.4%). More than half of the patients were in the Department of Cardiology, and other high-risk departments included Neurology, Nephrology, Vascular Surgery, Otolaryngology & Head Neck Surgery and Traditional Chinese Medicine (24.35%-31.51%). Overall, hypertension, coronary heart disease, carotid arteriosclerosis, hepatic cyst, arrhythmia, and nonalcoholic fatty liver disease were common accompanying diseases with FH.

Conclusions

It is necessary to establish appropriate diagnostic criteria and more positive treatment strategies for the FH inpatient population. In addition, promoting awareness of FH among doctors from other departments is also necessary. Therefore, developing a comprehensive management strategy for FH disease is very important.

Longitudinal lipidomic signatures of all-cause and CVD mortality in American Indians: findings from the Strong Heart Study

Dyslipidemia is an independent and modifiable risk factor for aging and age-related disorders. Routine lipid panel cannot capture all individual lipid species in blood (i.e., blood lipidome). To date, a comprehensive assessment of the blood lipidome associated with mortality is lacking in large-scale community-dwelling individuals, especially in a longitudinal setting. Using liquid chromatograph-mass spectrometry, we repeatedly measured individual lipid species in 3,821 plasma samples collected at two visits (~ 5.5 years apart) from 1,930 unique American Indians in the Strong Heart Family Study. We first identified baseline lipids associated with risks for all-cause mortality and CVD mortality (mean follow-up period: 17.8 years) in American Indians, followed by replication of top hits in European Caucasians in the Malmö Diet and Cancer-Cardiovascular Cohort (n = 3,943, mean follow-up period: 23.7 years). The model adjusted age, sex, BMI, smoking, hypertension, diabetes, and LDL-c at baseline. We then examined the associations between changes in lipid species and risk of mortality. Multiple testing was controlled by false discovery rate (FDR). We found that baseline levels and longitudinal changes of multiple lipid species, e.g., cholesterol esters, glycerophospholipids, sphingomyelins, and triacylglycerols, were significantly associated with risks of all-cause or CVD mortality. Many lipids identified in American Indians could be replicated in European Caucasians. Network analysis identified differential lipid networks associated with risk of mortality. Our findings provide novel insight into the role of dyslipidemia in disease mortality and offer potential biomarkers for early prediction and risk reduction in American Indians and other ethnic groups.

Long-Chain Acyl Carnitines Aggravate Polystyrene Nanoplastics-Induced Atherosclerosis by Upregulating MARCO

Exposure to micro- and nanoplastics (MNPs) is common because of their omnipresence in environment. Recent studies have revealed that MNPs may cause atherosclerosis, but the underlying mechanism remains unclear. To address this bottleneck, ApoE-/- mice are exposed to 2.5-250 mg kg-1 polystyrene nanoplastics (PS-NPs, 50 nm) by oral gavage with a high-fat diet for 19 weeks. It is found that PS-NPs in blood and aorta of mouse exacerbate the artery stiffness and promote atherosclerotic plaque formation. PS-NPs activate phagocytosis of M1-macrophage in the aorta, manifesting as upregulation of macrophage receptor with collagenous structure (MARCO). Moreover, PS-NPs disrupt lipid metabolism and increase long-chain acyl carnitines (LCACs). LCAC accumulation is attributed to the PS-NP-inhibited hepatic carnitine palmitoyltransferase 2. PS-NPs, as well as LCACs alone, aggravate lipid accumulation via upregulating MARCO in the oxidized low-density lipoprotein-activated foam cells. Finally, synergistic effects of PS-NPs and LCACs on increasing total cholesterol in foam cells are found. Overall, this study indicates that LCACs aggravate PS-NP-induced atherosclerosis by upregulating MARCO. This study offers new insight into the mechanisms underlying MNP-induced cardiovascular toxicity, and highlights the combined effects of MNPs with endogenous metabolites on the cardiovascular system, which warrant further study.

Novel wine in an old bottle: Preventive and therapeutic potentials of andrographolide in atherosclerotic cardiovascular diseases

Atherosclerotic cardiovascular disease (ASCVD) frequently results in sudden death and poses a serious threat to public health worldwide. The drugs approved for the prevention and treatment of ASCVD are usually used in combination but are inefficient owing to their side effects and single therapeutic targets. Therefore, the use of natural products in developing drugs for the prevention and treatment of ASCVD has received great scholarly attention. Andrographolide (AG) is a diterpenoid lactone compound extracted from Andrographis paniculata. In addition to its use in conditions such as sore throat, AG can be used to prevent and treat ASCVD. It is different from drugs that are commonly used in the prevention and treatment of ASCVD and can not only treat obesity, diabetes, hyperlipidaemia and ASCVD but also inhibit the pathological process of atherosclerosis (AS) including lipid accumulation, inflammation, oxidative stress and cellular abnormalities by regulating various targets and pathways. However, the pharmacological mechanisms of AG underlying the prevention and treatment of ASCVD have not been corroborated, which may hinder its clinical development and application. Therefore, this review summarizes the physiological and pathological mechanisms underlying the development of ASCVD and the in vivo and in vitro pharmacological effects of AG on the relative risk factors of AS and ASCVD. The findings support the use of the old pharmacological compound ('old bottle') as a novel drug ('novel wine') for the prevention and treatment of ASCVD. Additionally, this review summarizes studies on the availability as well as pharmaceutical and pharmacokinetic properties of AG, aiming to provide more information regarding the clinical application and further research and development of AG.

Peripheral Arterial Disease: A Narrative Review

Peripheral arterial disease (PAD) describes the partial or complete occlusion of blood flow in the distal arteries of the body. A decreased arterial patency may occur due to a reduction in the elasticity or diameter of the vessel. The goal of interventions is to decrease incidence and reduce complications by identifying and minimizing the primary causes. This paper discusses PAD affecting the aortoiliac, common femoral, and femoropopliteal arteries. In a significant portion of the population, PAD may lack usual symptoms such as limb pain, claudication, and diminished pulses. Imaging techniques become crucial to ensuring timely diagnosis, monitoring treatment effectiveness, and preventing recurrence. Duplex ultrasound (DUS) is a cheap and non-invasive preliminary technique to detect atherosclerotic plaques and grade arterial stenosis. Magnetic resonance angiography (MRA) provides the added advantage of minimizing artifacts. Digital subtraction angiography (DSA) remains the gold standard for grading the degree of stenosis but is only employed second-line to DUS or MRA due to the high dose of nephrotoxic contrast. Computed tomography angiography (CTA) is able to overcome the anatomical limitations of DUS and MRA and proves to be a suitable alternative to DSA in patients with renal disease. Preventative measures involve monitoring blood pressure, cholesterol levels, and tobacco usage. First-line treatment options include endovascular procedures as well as surgical interventions in cases of significant arterial involvement. Endovascular treatments involve the use of balloon angioplasty, drug-coated balloons, and drug-coated stents, to name a few, that serve as minimally invasive techniques to manage PAD. Surgical procedures, although more complex, are considered gold-standard treatment options for long and intricate lesions. Endovascular methods are generally preferred over surgical options as the complication risk is severely reduced and the rates of reintervention are comparable to surgical options.

Genetic and Environmental Influences on Blood Pressure and Serum Lipids Across Age-Groups

Aging plays a crucial role in the mechanisms of the impacts of genetic and environmental factors on blood pressure and serum lipids. However, to our knowledge, how the influence of genetic and environmental factors on the correlation between blood pressure and serum lipids changes with age remains to be determined. In this study, data from the Chinese National Twin Registry (CNTR) were used. Resting blood pressure, including systolic and diastolic blood pressure (SBP and DBP), and fasting serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) were measured in 2378 participants (1189 twin pairs). Univariate and bivariate structural equation models examined the genetic and environmental influences on blood pressure and serum lipids among three age groups. All phenotypes showed moderate to high heritability (0.37-0.59) and moderate unique environmental variance (0.30-0.44). The heritability of all phenotypes showed a decreasing trend with age. Among all phenotypes, SBP and DBP showed a significant monotonic decreasing trend. For phenotype-phenotype pairs, the phenotypic correlation (Rph) of each pair ranged from -0.04 to 0.23, and the additive genetic correlation (Ra) ranged from 0.00 to 0.36. For TC&SBP, TC&DBP, TG&SBP and TGs&DBP, both the Rph and Ra declined with age, and the Ra difference between the young group and the older adult group is statistically significant (p < .05). The unique environmental correlation (Re) of each pair did not follow any pattern with age and remained relatively stable with age. In summary, we observed that the heritability of blood pressure was affected by age. Moreover, blood pressure and serum lipids shared common genetic backgrounds, and age had an impact on the phenotypic correlation and genetic correlations.

Single-cell RNA-seq uncovers distinct pathways and genes in endothelial cells during atherosclerosis progression

Background: Atherosclerosis (AS) is a chronic inflammatory disease involving various cell types, cytokines, and adhesion molecules. Herein, we aimed to uncover its key molecular mechanisms by single-cell RNA-seq (scRNA-seq) analysis. Methods: ScRNA-seq data of cells from atherosclerotic human coronary arteries were analyzed using the Seurat package. Cell types were clustered, and differentially expressed genes (DEGs) were screened. GSVA (Gene Set Variation Analysis) scores of hub pathways were compared among different cell clusters. DEGs in endothelial cells between apolipoprotein-E (ApoE)^-/- mice and specific TGFbR1/2 KO ApoE^-/- mice fed with high-fat diet were overlapped with those from human AS coronary arteries. In fluid shear stress and AS, hub genes were determined based on the protein-protein interaction (PPI) network, which were verified in ApoE^-/- mice. Finally, hub genes were validated in three pairs of AS coronary arteries and normal tissues by histopathological examination. Results: ScRNA-seq identified nine cell clusters in human coronary arteries, namely, fibroblasts, endothelial cells, macrophages, B cells, adipocytes, HSCs, NK cells, CD8⁺ T cells, and monocytes. Among them, endothelial cells had the lowest fluid shear stress and AS and TGF-beta signaling pathway scores. Compared to ApoE^-/- mice fed with normal diet, fluid shear stress and AS and TGF-beta scores were both significantly lower in endothelial cells from TGFbR1/2 KO ApoE^-/- mice fed with normal or high-fat diet. Furthermore, the two hub pathways had a positive correlation. Three hub genes (ICAM1, KLF2, and VCAM1) were identified, and their expression was distinctly downregulated in endothelial cells from TGFbR1/2 KO ApoE^-/- mice fed with normal or high-fat diet than in those from ApoE^-/- mice fed with a normal diet, which were confirmed in human AS coronary artery. Conclusion: Our findings clarified the pivotal impacts of pathways (fluid shear stress and AS and TGF-beta) and genes (ICAM1, KLF2, and VCAM1) in endothelial cells on AS progression.

Attenuating lipid metabolism in atherosclerosis: The potential role of Anti-oxidative effects on low-density lipoprotein of herbal medicines

Atherosclerosis (AS) is a multifactorial chronic disease with great harm to the health of human being, which is a basic pathogenesis of many cardiovascular diseases and ultimately threatens human life. Abnormal blood lipid level is one of the most common diagnostic indicators of AS in clinic, and lipid metabolism disorder is often observed in patients with AS. Cholesterol is an important lipid in the human body, which is of great significance for maintaining normal life activities. Generally, cholesterol is transported to peripheral tissues by low-density lipoprotein (LDL), and then transported to the liver by high-density lipoprotein (HDL) via its cholesterol reverse transport function, and finally discharged. Under oxidative stress condition, LDL is commonly oxidized to the form ox-LDL, which is ingested by macrophages in large quantities and further forms foam cells, disrupting the normal metabolic process of cholesterol. Importantly, the foam cells are involved in forming atherosclerotic plaques, whose rupture may lead to ischemic heart disease or stroke. Furthermore, ox-LDL could also promote the development of AS by damaging vascular endothelium, promoting the migration and proliferation of smooth muscle cells, and activating platelets. Therefore, inhibiting LDL oxidation may be an effective way to improve lipid metabolism and prevent AS. In recent years, increasing studies have shown that herbal medicines have great potentiality in inhibiting LDL oxidation and reducing ox-LDL induced foam cell formation. Accordingly, this paper summarized current research on the inhibitory effects of herbal medicines against LDL oxidation and foam cell formation, and made a brief description of the role of cholesterol and LDL in lipid metabolism disorder and AS pathogenesis. Importantly, it is suggested that herbal medicines could inhibit LDL oxidation and regulate cholesterol homeostasis via downregulation of CD36 and SR-A, whereas upregulation of ABCA1 and ABCG1.