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Open AccessReview Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies

by Christophe Kosinski and François R. Jornayvaz

Nutrients 2017, 9(5), 517; doi:10.3390/nu9050517

Received: 7 March 2017 / Revised: 10 May 2017 / Accepted: 16 May 2017 / Published: 19 May 2017

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Abstract

The treatment of obesity and cardiovascular diseases is one of the most difficult and important challenges nowadays. Weight loss is frequently offered as a therapy and is aimed at improving some of the components of the metabolic syndrome. Among various diets, ketogenic diets,

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The treatment of obesity and cardiovascular diseases is one of the most difficult and important challenges nowadays. Weight loss is frequently offered as a therapy and is aimed at improving some of the components of the metabolic syndrome. Among various diets, ketogenic diets, which are very low in carbohydrates and usually high in fats and/or proteins, have gained in popularity. Results regarding the impact of such diets on cardiovascular risk factors are controversial, both in animals and humans, but some improvements notably in obesity and type 2 diabetes have been described. Unfortunately, these effects seem to be limited in time. Moreover, these diets are not totally safe and can be associated with some adverse events. Notably, in rodents, development of nonalcoholic fatty liver disease (NAFLD) and insulin resistance have been described. The aim of this review is to discuss the role of ketogenic diets on different cardiovascular risk factors in both animals and humans based on available evidence. Full article

(This article belongs to the Special Issue Nutrition and Diet Factors in Type 2 Diabetes)

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Open AccessReview Nutraceutical Value of Citrus Flavanones and Their Implications in Cardiovascular Disease

by Lara Testai and Vincenzo Calderone

Nutrients 2017, 9(5), 502; doi:10.3390/nu9050502

Received: 29 March 2017 / Revised: 8 May 2017 / Accepted: 10 May 2017 / Published: 16 May 2017

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Abstract

Background- Cardiovascular diseases, including myocardial infarction, dyslipidaemia and coronary artery pathology, are a major cause of illness and death in Western countries. Therefore, identifying effective therapeutic approaches and their cellular signalling pathways is a challenging goal for medicine. In this regard, several epidemiological

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Background- Cardiovascular diseases, including myocardial infarction, dyslipidaemia and coronary artery pathology, are a major cause of illness and death in Western countries. Therefore, identifying effective therapeutic approaches and their cellular signalling pathways is a challenging goal for medicine. In this regard, several epidemiological studies demonstrate a relationship between the intake of flavonoid-rich foods and the reduction of cardiovascular risk factors and mortality. In particular, flavonoids present in citrus fruits, such as oranges, bergamots, lemons and grapefruit (95% from flavanones), are emerging for their considerable nutraceutical value. Methods- In this review an examination of literature was performed while considering both epidemiological, clinical and pre-clinical evidence supporting the beneficial role of the flavanone class. We evaluated studies in which citrus fruit juices or single flavanone administration and cardiovascular risk factors were analysed; to identify these studies, an electronic search was conducted in PUBMED for papers fulfilling these criteria and written in English. Results- In addition to epidemiological evidence and clinical studies demonstrating that fruits in the Citrus genus significantly reduce the incidence of cardiovascular disease risk, pre-clinical investigations highlight cellular and subcellular targets that are responsible for these beneficial effects. There has been special attention on evaluating intracellular pathways involved in direct cardiovascular and cardiometabolic effects mediated by naringenin, hesperetin and eriodictyol or their glycosylated derivatives. Conclusions- Although some mechanisms of action remain unclear and bioavailability problems remain to be solved, the current evidence supports the use of a nutraceutical approach with citrus fruits to prevent and cure several aspects of cardiovascular disease. Full article

(This article belongs to the Special Issue Effects of Polyphenol-Rich Foods on Human Health)

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Open AccessReview Beyond the Cholesterol-Lowering Effect of Soy Protein: A Review of the Effects of Dietary Soy and Its Constituents on Risk Factors for Cardiovascular Disease

by D. Dan Ramdath, Emily M. T. Padhi, Sidra Sarfaraz, Simone Renwick and Alison M. Duncan

Nutrients 2017, 9(4), 324; doi:10.3390/nu9040324

Received: 5 February 2017 / Revised: 16 March 2017 / Accepted: 21 March 2017 / Published: 24 March 2017

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Abstract

The hypocholesterolemic effect of soy is well-documented and this has led to the regulatory approval of a health claim relating soy protein to a reduced risk of cardiovascular disease (CVD). However, soybeans contain additional components, such as isoflavones, lecithins, saponins and fiber that

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The hypocholesterolemic effect of soy is well-documented and this has led to the regulatory approval of a health claim relating soy protein to a reduced risk of cardiovascular disease (CVD). However, soybeans contain additional components, such as isoflavones, lecithins, saponins and fiber that may improve cardiovascular health through independent mechanisms. This review summarizes the evidence on the cardiovascular benefits of non-protein soy components in relation to known CVD risk factors such as hypertension, hyperglycemia, inflammation, and obesity beyond cholesterol lowering. Overall, the available evidence suggests non-protein soy constituents improve markers of cardiovascular health; however, additional carefully designed studies are required to independently elucidate these effects. Further, work is also needed to clarify the role of isoflavone-metabolizing phenotype and gut microbiota composition on biological effect. Full article

(This article belongs to the Special Issue Health Benefits of Soybean and other Grain Legumes)

Open AccessArticle Association between Coffee Consumption and Its Polyphenols with Cardiovascular Risk Factors: A Population-Based Study

by Andreia Machado Miranda, Josiane Steluti, Regina Mara Fisberg and Dirce Maria Marchioni

Nutrients 2017, 9(3), 276; doi:10.3390/nu9030276

Received: 26 January 2017 / Revised: 9 March 2017 / Accepted: 10 March 2017 / Published: 14 March 2017

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Abstract

Epidemiological studies have examined the effect of coffee intake on cardiovascular disease, but the benefits and risks for the cardiovascular system remain controversial. Our objective was to evaluate the association between coffee consumption and its polyphenols on cardiovascular risk factors. Data came from

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Epidemiological studies have examined the effect of coffee intake on cardiovascular disease, but the benefits and risks for the cardiovascular system remain controversial. Our objective was to evaluate the association between coffee consumption and its polyphenols on cardiovascular risk factors. Data came from the “Health Survey of São Paulo (ISA-Capital)” among 557 individuals, in São Paulo, Brazil. Diet was assessed by two 24-h dietary recalls. Coffee consumption was categorized into <1, 1–3, and ≥3 cups/day. Polyphenol intake was calculated by matching food consumption data with the Phenol-Explorer database. Multiple logistic regression models were used to assess the associations between cardiovascular risk factors (blood pressure, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, fasting glucose, and homocysteine) and usual coffee intake. The odds were lower among individuals who drank 1–3 cups of coffee/day to elevated systolic blood pressure (SBP) (Odds Ratio (OR) = 0.45; 95% Confidence Interval (95% CI): 0.26, 0.78), elevated diastolic blood pressure (DBP) (OR = 0.44; 95% CI: 0.20, 0.98), and hyperhomocysteinemia (OR = 0.32; 95% CI: 0.11, 0.93). Furthermore, significant inverse associations were also observed between moderate intake of coffee polyphenols and elevated SBP (OR = 0.46; 95% CI: 0.24, 0.87), elevated DBP (OR = 0.51; 95% CI: 0.26, 0.98), and hyperhomocysteinemia (OR = 0.29; 95% CI: 0.11, 0.78). In conclusion, coffee intake of 1–3 cups/day and its polyphenols were associated with lower odds of elevated SBP, DBP, and hyperhomocysteinemia. Thus, the moderate consumption of coffee, a polyphenol-rich beverage, could exert a protective effect against some cardiovascular risk factors. Full article

(This article belongs to the Special Issue Effects of Polyphenol-Rich Foods on Human Health)

Open AccessArticle Assessment of Knowledge of Critical Cardiovascular Risk Indicators among College Students: Does Stage of Education Matter?

by Daniel F. Sarpong, India Y. Curry and Melinda Williams

Int. J. Environ. Res. Public Health 2017, 14(3), 250; doi:10.3390/ijerph14030250

Received: 2 January 2017 / Revised: 16 February 2017 / Accepted: 25 February 2017 / Published: 2 March 2017

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Abstract

The health risk of college students in the United States (US) is on the rise, with a significant increase in the prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in the US, costing approximately $475.3 billion yearly. The

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The health risk of college students in the United States (US) is on the rise, with a significant increase in the prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in the US, costing approximately $475.3 billion yearly. The goals of this “Know Your Numbers” study were to: (1) estimate the awareness of college students of their critical health numbers (CHN); and (2) compare a college of pharmacy entry class (IP1) with second semester non-commuter freshman college students (FCS) in knowing their numbers. A cross-sectional 15-item pre-test survey was conducted among a convenience sample of IP1 and FCS. All statistical tests were performed at α = 0.05. Awareness of their: cholesterol (7%), blood pressure (BP) (35%), glucose (8%), and body mass index (BMI) (42%) were low. The IP1, compared to FCS, were more knowledgeable of: (1) their BP (46% vs. 28%, p = 0.01); (2) BP normal range (74% vs. 63%, p = 0.02); and (3) BMI normal range (39% vs. 23%, p = 0.04). The IP1s maintained a healthier diet than the FCS (64% vs. 36%, p < 0.0001). Awareness of knowing CHN was very low. Knowledge of one’s CHN was significantly associated with knowledge of normal reference values for BP, glucose, and BMI. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

Open AccessArticle Optimistic Bias, Risk Factors, and Development of High Blood Pressure and Obesity among African American Adolescents in Mississippi (USA)

by Monique S. White, Clifton C. Addison, Brenda W. Campbell Jenkins, Vanessa Bland, Adrianne Clark and Donna Antoine LaVigne

Int. J. Environ. Res. Public Health 2017, 14(2), 209; doi:10.3390/ijerph14020209

Received: 26 December 2016 / Accepted: 17 February 2017 / Published: 20 February 2017

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Abstract

Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and

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Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Engaging in moderate exercise for at least 30 min in the last 7 days and lower blood pressure was the only statistically significant relationship. Two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease with males at greater risk than females, despite the presence of clinical risk factors for hypertension and obesity. Reducing health optimistic bias is an effective way of motivating young people to adopt more positive behaviors using educational institutions to implement intervention programs that promote positive health behavior as a way to reduce health disparities. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

Open AccessArticle Arsenic Exposure and Predicted 10-Year Atherosclerotic Cardiovascular Risk Using the Pooled Cohort Equations in U.S. Hypertensive Adults

by Qingjiao Nong, Yiyi Zhang, Eliseo Guallar and Qiuan Zhong

Int. J. Environ. Res. Public Health 2016, 13(11), 1093; doi:10.3390/ijerph13111093

Received: 29 August 2016 / Revised: 31 October 2016 / Accepted: 1 November 2016 / Published: 7 November 2016

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Abstract

This study was to evaluate the association of urine arsenic with predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk in U.S. adults with hypertension. Cross-sectional analysis was conducted in 1570 hypertensive adults aged 40–79 years in the 2003–2012 National Health and Nutrition Examination Survey

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This study was to evaluate the association of urine arsenic with predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk in U.S. adults with hypertension. Cross-sectional analysis was conducted in 1570 hypertensive adults aged 40–79 years in the 2003–2012 National Health and Nutrition Examination Survey (NHANES) with determinations of urine arsenic. Predicted 10-year ASCVD risk was estimated by the Pooled Cohort Equations, developed by the American College of Cardiology/American Heart Association in 2013. For men, after adjustment for sociodemographic factors, urine dilution, ASCVD risk factors and organic arsenic intake from seafood, participants in the highest quartiles of urine arsenic had higher 10-year predicted ASCVD risk than in the lowest quartiles; the increases were 24% (95% confidence interval (CI): 2%, 53%) for total arsenic, 13% (95% CI: 2%, 25%) for dimethylarsinate and 22% (95% CI: 5%, 40%) for total arsenic minus arsenobetaine separately. For women, the corresponding increases were 5% (95% CI: −15%, 29%), 10% (95% CI: −8%, 30%) and 0% (95% CI: −15%, 19%), respectively. Arsenic exposure, even at low levels, may contribute to increased ASCVD risk in men with hypertension. Furthermore, our findings suggest that particular circumstances need urgently to be considered while elucidating cardiovascular effects of low inorganic arsenic levels. Full article

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Open AccessArticle Adherence to the “Mediterranean Diet” in Spain and Its Relationship with Cardiovascular Risk (DIMERICA Study)

by José Abellán Alemán, María Pilar Zafrilla Rentero, Silvia Montoro-García, Juana Mulero, Alfonso Pérez Garrido, Mariano Leal, Lucía Guerrero, Elena Ramos and Luis Miguel Ruilope

Nutrients 2016, 8(11), 680; doi:10.3390/nu8110680

Received: 18 July 2016 / Revised: 16 September 2016 / Accepted: 20 October 2016 / Published: 28 October 2016

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Abstract

Background: Nutritional studies focus on traditional cultural models and lifestyles in different countries. The aim of this study was to examine the adherence to the Mediterranean diet, life habits, and risk factors associated with cardiovascular diseases among people living in different geographical regions

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Background: Nutritional studies focus on traditional cultural models and lifestyles in different countries. The aim of this study was to examine the adherence to the Mediterranean diet, life habits, and risk factors associated with cardiovascular diseases among people living in different geographical regions in Spain. Methods: A descriptive cross-sectional study was conducted in each region. The sampling scheme consisted of a random three-stage stratified sampling program according to geographic region, age, and gender. A total of 1732 subjects were asked to complete a questionnaire designed to assess their nutrient intake, dietary habits, and exercise. A diet score that assesses the adherence of participants to the Mediterranean diet (range 0–10) was also applied. Results: Southeastern Spain had the lowest score for adherence to the Mediterranean diet because of the low consumption of fish and plant products. A lower adherence score to the Mediterranean diet was strongly associated with the prevalence of hypertension (p = 0.018). Conclusions: A low level of adherence to the Mediterranean diet is accompanied by a high prevalence of hypertension and, therefore, a raised cardiovascular risk in the country. The adherence score could help identify individuals at greater cardiovascular risk. Full article

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Open AccessArticle Association of Parental Overweight and Cardiometabolic Diseases and Pediatric Adiposity and Lifestyle Factors with Cardiovascular Risk Factor Clustering in Adolescents

by Chun-Ying Lee, Wei-Ting Lin, Sharon Tsai, Yu-Chan Hung, Pei-Wen Wu, Yu-Cheng Yang, Te-Fu Chan, Hsiao-Ling Huang, Yao-Lin Weng, Yu-Wen Chiu, Chia-Tsuan Huang and Chien-Hung Lee

Nutrients 2016, 8(9), 567; doi:10.3390/nu8090567

Received: 21 May 2016 / Revised: 30 July 2016 / Accepted: 5 September 2016 / Published: 13 September 2016

Abstract

Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and

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Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12–16 years) were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1–2 and ≥3 risk components for pediatric metabolic syndrome (MetS) were defined as potential MetS (pot-MetS) and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5–1.6 and 1.9–4.2-fold, respectively). Low physical activity (<952.4 MET·min/week), long screen time (≥3 h/day) and high sugar-sweetened beverage intake (>500 mL/day) were associated with a 3.3- (95% confidence intervals (CI) = 1.5–7.3), 2.2- (95% CI = 1.1–4.4), and 26.9-fold (95% CI = 3.2–229.0) odds ratio (OR) of MetS, respectively. Pediatric body mass index (BMI) accounted for 18.8%–95.6% and 16.9%–60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3–17.3); p for multiplicative interaction, 0.009). The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI explains a part of these associations. Pediatric adiposity might be multiplicatively associated with sugar-sweetened beverage consumption for enhancing the MetS prevalence ratio among adolescents. Full article

Open AccessReview Advances in Integrating Traditional and Omic Biomarkers When Analyzing the Effects of the Mediterranean Diet Intervention in Cardiovascular Prevention

by Montserrat Fitó, Olle Melander, José Alfredo Martínez, Estefanía Toledo, Christian Carpéné and Dolores Corella

Int. J. Mol. Sci. 2016, 17(9), 1469; doi:10.3390/ijms17091469

Received: 19 June 2016 / Revised: 8 August 2016 / Accepted: 26 August 2016 / Published: 2 September 2016

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Abstract

Intervention with Mediterranean diet (MedDiet) has provided a high level of evidence in primary prevention of cardiovascular events. Besides enhancing protection from classical risk factors, an improvement has also been described in a number of non-classical ones. Benefits have been reported on biomarkers

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Intervention with Mediterranean diet (MedDiet) has provided a high level of evidence in primary prevention of cardiovascular events. Besides enhancing protection from classical risk factors, an improvement has also been described in a number of non-classical ones. Benefits have been reported on biomarkers of oxidation, inflammation, cellular adhesion, adipokine production, and pro-thrombotic state. Although the benefits of the MedDiet have been attributed to its richness in antioxidants, the mechanisms by which it exercises its beneficial effects are not well known. It is thought that the integration of omics including genomics, transcriptomics, epigenomics, and metabolomics, into studies analyzing nutrition and cardiovascular diseases will provide new clues regarding these mechanisms. However, omics integration is still in its infancy. Currently, some single-omics analyses have provided valuable data, mostly in the field of genomics. Thus, several gene-diet interactions in determining both intermediate (plasma lipids, etc.) and final cardiovascular phenotypes (stroke, myocardial infarction, etc.) have been reported. However, few studies have analyzed changes in gene expression and, moreover very few have focused on epigenomic or metabolomic biomarkers related to the MedDiet. Nevertheless, these preliminary results can help to better understand the inter-individual differences in cardiovascular risk and dietary response for further applications in personalized nutrition. Full article

(This article belongs to the Special Issue Advances in Nutritional Epidemiology)

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Open AccessReview Telomeres and Telomerase in Cardiovascular Diseases

by Jih-Kai Yeh and Chao-Yung Wang

Genes 2016, 7(9), 58; doi:10.3390/genes7090058

Received: 15 May 2016 / Revised: 25 August 2016 / Accepted: 29 August 2016 / Published: 1 September 2016

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Abstract

Telomeres are tandem repeat DNA sequences present at the ends of each eukaryotic chromosome to stabilize the genome structure integrity. Telomere lengths progressively shorten with each cell division. Inflammation and oxidative stress, which are implicated as major mechanisms underlying cardiovascular diseases, increase the

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Telomeres are tandem repeat DNA sequences present at the ends of each eukaryotic chromosome to stabilize the genome structure integrity. Telomere lengths progressively shorten with each cell division. Inflammation and oxidative stress, which are implicated as major mechanisms underlying cardiovascular diseases, increase the rate of telomere shortening and lead to cellular senescence. In clinical studies, cardiovascular risk factors such as smoking, obesity, sedentary lifestyle, and hypertension have been associated with short leukocyte telomere length. In addition, low telomerase activity and short leukocyte telomere length have been observed in atherosclerotic plaque and associated with plaque instability, thus stroke or acute myocardial infarction. The aging myocardium with telomere shortening and accumulation of senescent cells limits the tissue regenerative capacity, contributing to systolic or diastolic heart failure. In addition, patients with ion-channel defects might have genetic imbalance caused by oxidative stress-related accelerated telomere shortening, which may subsequently cause sudden cardiac death. Telomere length can serve as a marker for the biological status of previous cell divisions and DNA damage with inflammation and oxidative stress. It can be integrated into current risk prediction and stratification models for cardiovascular diseases and can be used in precise personalized treatments. In this review, we summarize the current understanding of telomeres and telomerase in the aging process and their association with cardiovascular diseases. In addition, we discuss therapeutic interventions targeting the telomere system in cardiovascular disease treatments. Full article

(This article belongs to the Special Issue Telomerase Activity in Human Cells)

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Open AccessArticle Distribution of High-Sensitivity C-Reactive Protein and Its Relationship with Other Cardiovascular Risk Factors in the Middle-Aged Chinese Population

by Zengwu Wang, Xin Wang, Zuo Chen, Linfeng Zhang and Manlu Zhu

Int. J. Environ. Res. Public Health 2016, 13(9), 872; doi:10.3390/ijerph13090872

Received: 11 June 2016 / Revised: 22 August 2016 / Accepted: 26 August 2016 / Published: 31 August 2016

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Abstract

Background: An increased concentration of high-sensitivity C-reactive protein (hs-CRP) indicates risk for cardiovascular disease (CVD). Because the available data is limited, a cross-sectional survey was conducted in 2009–2010 to describe hs-CRP distribution and its relationship with established CVD risk factors. Methods: A population-based

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Background: An increased concentration of high-sensitivity C-reactive protein (hs-CRP) indicates risk for cardiovascular disease (CVD). Because the available data is limited, a cross-sectional survey was conducted in 2009–2010 to describe hs-CRP distribution and its relationship with established CVD risk factors. Methods: A population-based sample of adults aged 35 to 64 years (n = 14,046) was taken from 12 research populations across China. Demographic and clinical characteristics were recorded, and hs-CRP measured. Pearson’s and Kendall’s tau-b correlation coefficient, and multiple regression analyses were used to test the relationship between hs-CRP and other CVD risk factors. Results: For 8389 (4412 females) eligible participants, hs-CRP was 1.89 ± 4.37 mg/L (median (25th, 75th): 0.80 (0.40, 1.80)), and increased with age, BP, glucose, and BMI (p < 0.05), males had significantly higher hs-CRP than females (2.07 (4.89) vs. 1.73 (3.83), p < 0.001). About 24.3% had the hs-CRP concentrations more than the top quartile (25.8% in males, 22.9% in females), 12.3% (13.3% in males, 11.5% in females) >3 mg/L. There was a significant positive correlation of quartiles of hs-CRP concentrations with age, SBP, DBP, glucose level, BMI, LDL-C/HDL-C ratio, and LDL-C/total cholesterol ratio (p < 0.001). The elevated hs-CRP (>1.80 mg/L) related positively with age, LDL-C, BP, glucose, BMI, and living north and negatively with HDL-C/TC, LDL-C/TC, TC independently (p < 0.05). For subjects with coexisting hypertension, diabetes, high cholesterol, and obesity, about 63.0% were in the top quartile of hs-CRP concentrations. Conclusions: Hs-CRP was associated with most of the known CVD risk factors. Measurement of hs-CRP may provide a more comprehensive view of the patient’s overall risk profile in the Chinese population. Full article

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Open AccessArticle Comparison of the Combined Obesity Indices to Predict Cardiovascular Diseases Risk Factors and Metabolic Syndrome in Northeast China

by Yuchun Tao, Jianxing Yu, Yuhui Tao, Hui Pang, Yang Yu, Yaqin Yu and Lina Jin

Int. J. Environ. Res. Public Health 2016, 13(8), 801; doi:10.3390/ijerph13080801

Received: 14 June 2016 / Revised: 28 July 2016 / Accepted: 2 August 2016 / Published: 9 August 2016

Abstract

Background: Obesity is associated with cardiovascular disease (CVD) risk factors (hypertension, dyslipidemia and diabetes) and metabolic syndrome (MetS), and it may be flawed that most studies only use one obesity index to predict these risk factors. Therefore, our study aims to compare

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Background: Obesity is associated with cardiovascular disease (CVD) risk factors (hypertension, dyslipidemia and diabetes) and metabolic syndrome (MetS), and it may be flawed that most studies only use one obesity index to predict these risk factors. Therefore, our study aims to compare the various combined obesity indices systematically, and to find the optimal combined obesity indices to predict CVD risk factors and MetS. Methods: A total of 16,766 participants aged 18–79 years old were recruited in Jilin Province in 2012. Receiver operating characteristic curve (ROC) curves and multiple logistic regressions were used to evaluate the predictive capacity of the combined obesity indices for CVD risk factors and MetS. Results: The adjusted area under receiver operating characteristic (AUROC) with two combined obesity indices had been improved up to 19.45%, compared with one single obesity index. In addition, body mass index (BMI) and waist circumference (WC) were the optimal combinations, where the AUROC (95% confidence interval (CI)) for hypertension, dyslipidemia, diabetes and MetS in males were 0.730 (0.718, 0.740), 0.694 (0.682, 0.706), 0.725 (0.709, 0.742) and 0.820 (0.810, 0.830), and in females were 0.790 (0.780, 0.799), 0.727 (0.717, 0.738), 0.746 (0.731, 0.761) and 0.828 (0.820, 0.837), respectively. Conclusions: The more abnormal obesity indices that one has the higher the risk for CVD risk factors and MetS, especially in males. In addition, the combined obesity indices have better predictions than one obesity index, where BMI and WC are the optimal combinations. Full article

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Open AccessArticle Types of Obesity and Its Association with the Clustering of Cardiovascular Disease Risk Factors in Jilin Province of China

by Peng Zhang, Rui Wang, Chunshi Gao, Yuanyuan Song, Xin Lv, Lingling Jiang, Yaqin Yu, Yuhan Wang and Bo Li

Int. J. Environ. Res. Public Health 2016, 13(7), 685; doi:10.3390/ijerph13070685

Received: 28 May 2016 / Revised: 27 June 2016 / Accepted: 1 July 2016 / Published: 7 July 2016

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Abstract

Cardiovascular disease (CVD) has become a serious public health problem in recent years in China. Aggregation of CVD risk factors in one individual increases the risk of CVD and the risk increases substantially with each additional risk factor. This study aims to explore

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Cardiovascular disease (CVD) has become a serious public health problem in recent years in China. Aggregation of CVD risk factors in one individual increases the risk of CVD and the risk increases substantially with each additional risk factor. This study aims to explore the relationship between the number of clustered CVD risk factors and different types of obesity. A multistage stratified random cluster sampling design was used in this population-based cross-sectional study in 2012. Information was collected by face to face interviews. One-way analysis of variance (ANOVA), chi-square test, Kruskal-Wallis test and multiple logistic regression were used in this study. The prevalence of general obesity, central obesity and compound obesity were 0.3%, 36.1% and 14.7%, respectively. The prevalence of hypertension, hyperlipidemia and diabetes in the compound obesity group were higher than those in other groups (compound obesity > central obesity > general obesity > non-obesity), while smoking rate in the non-obesity group was higher than those in other groups (non-obesity > general obesity > central obesity > compound obesity). People with obesity were more likely to have one or more CVD risk factor compared with non-obesity subjects (general obesity (OR: 2.27, 95% CI: 1.13–4.56), central obesity (OR: 2.64, 95% CI: 2.41–2.89), compound obesity (OR: 5.09, 95% CI: 4.38–5.90). The results were similar when the number of clustered CVD risk factors was ≥ 2 and ≥ 3. As a conclusion, more than half of the residents in Jilin Province have a problem of obesity, especially central obesity. Government and health department should take measures to improve people’s awareness of central obesity in Jilin Province of China. The prevalence of hypertension, hyperlipidemia and diabetes are associated with obesity types. Compound obesity has a greater risk to cluster multiple CVD risk factors than central obesity and general obesity. Taking measures to control obesity will reduce the prevalence of CVD in Jilin Province. Full article

Open AccessArticle Evaluation of the Effectiveness of Tai Chi versus Brisk Walking in Reducing Cardiovascular Risk Factors: Protocol for a Randomized Controlled Trial

by Aileen W. K. Chan, Janet W. H. Sit, Sek Ying Chair, Doris Y. P. Leung, Diana T. F. Lee, Eliza M. L. Wong and Lawrence C. W. Fung

Int. J. Environ. Res. Public Health 2016, 13(7), 682; doi:10.3390/ijerph13070682

Received: 23 May 2016 / Revised: 30 June 2016 / Accepted: 30 June 2016 / Published: 5 July 2016

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Abstract

Physical inactivity is one of the major modifiable lifestyle risk factors for cardiovascular disease (CVD). This protocol aims to evaluate the effectiveness of Tai Chi versus brisk walking in reducing CVD risk factors. This is a randomized controlled trial with three arms, namely,

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Physical inactivity is one of the major modifiable lifestyle risk factors for cardiovascular disease (CVD). This protocol aims to evaluate the effectiveness of Tai Chi versus brisk walking in reducing CVD risk factors. This is a randomized controlled trial with three arms, namely, Tai Chi group, walking group, and control group. The Tai Chi group will receive Tai Chi training, which consists of two 60-min sessions each week for three months, and self-practice for 30 min every day. The walking group will perform brisk walking for 30 min every day. The control group will receive their usual care. 246 subjects with CVD risk factors will be recruited from two outpatient clinics. The primary outcome is blood pressure. Secondary outcomes include fasting blood for lipid profile, sugar and glycated haemoglobin (HbA1c); body mass index, waist circumference, body fat percentage; perceived stress level and quality of life. Data collections will be conducted at baseline, 3-month, 6-month and 9-month. Generalized estimating equations model will be used to compare the changes in outcomes across time between groups. It is expected that both the Tai Chi and walking groups could maintain better health and have improved quality of life, and that Tai Chi will be more effective than brisk walking in reducing CVD risk factors. Full article

Open AccessReview Physical Activity Programs with Post-Intervention Follow-Up in Children: A Comprehensive Review According to Categories of Intervention

by Sally Nguyen, Anna-Luisa Häcker, Melanie Henderson, Tracie Barnett, Marie-Eve Mathieu, Linda Pagani and Jean-Luc Bigras

Int. J. Environ. Res. Public Health 2016, 13(7), 664; doi:10.3390/ijerph13070664

Received: 7 March 2016 / Revised: 23 June 2016 / Accepted: 24 June 2016 / Published: 30 June 2016

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Abstract

Only 9% of Canadian children meet the National Guidelines of 60 min of daily moderate-to-vigorous intensity physical activity. The aim of this review is to assess the mid- and long-term effectiveness of physical activity interventions and their impact on cardiovascular risk factors in

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Only 9% of Canadian children meet the National Guidelines of 60 min of daily moderate-to-vigorous intensity physical activity. The aim of this review is to assess the mid- and long-term effectiveness of physical activity interventions and their impact on cardiovascular risk factors in children. We assessed the success of interventions within three different categories: those using a behavioural and social approach, an informational approach or an environmental approach. The average number of children included in these studies was 860 (range of 30–5106); the age range was from 2 to 18 years; and the mean intervention duration was 1607 min (range of 12–8160 min). The length of follow-up post-intervention averaged 13 months (ranging from 0.25 to 96 months). A positive impact on physical activity was found in 74% and on any measured outcomes in 90% of the studies reviewed. However, the benefits of physical activity interventions decreased with longer follow-up. Regardless of the approaches, physical activity interventions improved cardiovascular risk factors. However, the challenge of any program is to maintain beneficial effects once the intervention is completed. These findings will inform the development of future intervention programs in order to optimize sustained cardiovascular benefits. Full article

Open AccessReview Nutraceuticals and Bioactive Components from Fish for Dyslipidemia and Cardiovascular Risk Reduction

by Giulia Chiesa, Marco Busnelli, Stefano Manzini and Cinzia Parolini

Mar. Drugs 2016, 14(6), 113; doi:10.3390/md14060113

Received: 9 March 2016 / Revised: 11 May 2016 / Accepted: 26 May 2016 / Published: 8 June 2016

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Abstract

Cardiovascular disease remains the most common health problem in developed countries, and residual risk after implementing all current therapies is still high. Permanent changes in lifestyle may be hard to achieve and people may not always be motivated enough to make the recommended

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Cardiovascular disease remains the most common health problem in developed countries, and residual risk after implementing all current therapies is still high. Permanent changes in lifestyle may be hard to achieve and people may not always be motivated enough to make the recommended modifications. Emerging research has explored the application of natural food-based strategies in disease management. In recent years, much focus has been placed on the beneficial effects of fish consumption. Many of the positive effects of fish consumption on dyslipidemia and heart diseases have been attributed to n-3 polyunsaturated fatty acids (n-3 PUFAs, i.e., EPA and DHA); however, fish is also an excellent source of protein and, recently, fish protein hydrolysates containing bioactive peptides have shown promising activities for the prevention/management of cardiovascular disease and associated health complications. The present review will focus on n-3 PUFAs and bioactive peptides effects on cardiovascular disease risk factors. Moreover, since considerable controversy exists regarding the association between n-3 PUFAs and major cardiovascular endpoints, we have also reviewed the main clinical trials supporting or not this association. Full article

(This article belongs to the Special Issue Marine Natural Products that Target Metabolic Disorders)

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Open AccessArticle Cardiovascular, Metabolic Effects and Dietary Composition of Ad-Libitum Paleolithic vs. Australian Guide to Healthy Eating Diets: A 4-Week Randomised Trial

by Angela Genoni, Philippa Lyons-Wall, Johnny Lo and Amanda Devine

Nutrients 2016, 8(5), 314; doi:10.3390/nu8050314

Received: 9 March 2016 / Revised: 16 May 2016 / Accepted: 17 May 2016 / Published: 23 May 2016

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Abstract

(1) Background: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with

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(1) Background: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with a secondary aim to examine the macro and micronutrient composition of both dietary patterns; (2) Methods: 39 healthy women (mean ± SD age 47 ± 13 years, BMI 27 ± 4 kg/m²) were randomised to either the Paleolithic (n = 22) or AGHE diet (n = 17) for four weeks. Three-day weighed food records, body composition and biochemistry data were collected pre and post intervention; (3) Results: Significantly greater weight loss occurred in the Paleolithic group (−1.99 kg, 95% CI −2.9, −1.0), p < 0.001). There were no differences in cardiovascular and metabolic markers between groups. The Paleolithic group had lower intakes of carbohydrate (−14.63% of energy (E), 95% CI −19.5, −9.7), sodium (−1055 mg/day, 95% CI −1593, −518), calcium (−292 mg/day 95% CI −486.0, −99.0) and iodine (−47.9 μg/day, 95% CI −79.2, −16.5) and higher intakes of fat (9.39% of E, 95% CI 3.7, 15.1) and β-carotene (6777 μg/day 95% CI 2144, 11410) (all p < 0.01); (4) Conclusions: The Paleolithic diet induced greater changes in body composition over the short-term intervention, however, larger studies are recommended to assess the impact of the Paleolithic vs. AGHE diets on metabolic and cardiovascular risk factors in healthy populations. Full article

(This article belongs to the Special Issue Selected Papers from 2015 Joint Scientific Meeting of the Nutrition Society of New Zealand and Nutrition Society of Australia)

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Open AccessReview Nutritional Genomics and the Mediterranean Diet’s Effects on Human Cardiovascular Health

by Montserrat Fitó and Valentini Konstantinidou

Nutrients 2016, 8(4), 218; doi:10.3390/nu8040218

Received: 11 October 2015 / Revised: 30 March 2016 / Accepted: 7 April 2016 / Published: 13 April 2016

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Abstract

The synergies and cumulative effects among different foods and nutrients are what produce the benefits of a healthy dietary pattern. Diets and dietary patterns are a major environmental factor that we are exposed to several times a day. People can learn how to

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The synergies and cumulative effects among different foods and nutrients are what produce the benefits of a healthy dietary pattern. Diets and dietary patterns are a major environmental factor that we are exposed to several times a day. People can learn how to control this behavior in order to promote healthy living and aging, and to prevent diet-related diseases. To date, the traditional Mediterranean diet has been the only well-studied pattern. Stroke incidence, a number of classical risk factors including lipid profile and glycaemia, emergent risk factors such as the length of telomeres, and emotional eating behavior can be affected by genetic predisposition. Adherence to the Mediterranean diet could exert beneficial effects on these risk factors. Our individual genetic make-up should be taken into account to better prevent these traits and their subsequent consequences in cardiovascular disease development. In the present work, we review the results of nutritional genomics explaining the role of the Mediterranean diet in human cardiovascular disease. A multidisciplinary approach is necessary to extract knowledge from large-scale data. Full article

(This article belongs to the Special Issue Dietary Pattern and Health)

Open AccessArticle Fructose Containing Sugars at Normal Levels of Consumption Do Not Effect Adversely Components of the Metabolic Syndrome and Risk Factors for Cardiovascular Disease

by Theodore J. Angelopoulos, Joshua Lowndes, Stephanie Sinnett and James M. Rippe

Nutrients 2016, 8(4), 179; doi:10.3390/nu8040179

Received: 13 July 2015 / Accepted: 10 March 2016 / Published: 23 March 2016

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Abstract

The objective of the current study was to explore our hypothesis that average consumption of fructose and fructose containing sugars would not increase risk factors for cardiovascular disease (CVD) and the metabolic syndrome (MetS). A randomized, double blind, parallel group study was conducted

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The objective of the current study was to explore our hypothesis that average consumption of fructose and fructose containing sugars would not increase risk factors for cardiovascular disease (CVD) and the metabolic syndrome (MetS). A randomized, double blind, parallel group study was conducted where 267 individuals with BMI between 23 and 35 kg/m² consumed low fat sugar sweetened milk, daily for ten weeks as part of usual weight-maintenance diet. One group consumed 18% of calories from high fructose corn syrup (HFCS), another group consumed 18% of calories from sucrose, a third group consumed 9% of calories from fructose, and the fourth group consumed 9% of calories from glucose. There was a small change in waist circumference (80.9 ± 9.5 vs. 81.5 ± 9.5 cm) in the entire cohort, as well as in total cholesterol (4.6 ± 1.0 vs. 4.7 ± 1.0 mmol/L, p < 0.01), triglycerides (TGs) (11.5 ± 6.4 vs. 12.6 ± 8.9 mmol/L, p < 0.01), and systolic (109.2 ± 10.2 vs. 106.1 ± 10.4 mmHg, p < 0.01) and diastolic blood pressure (69.8 ± 8.7 vs. 68.1 ± 9.7 mmHg, p < 0.01). The effects of commonly consumed sugars on components of the MetS and CVD risk factors are minimal, mixed and not clinically significant. Full article

Open AccessArticle Tomato Sauce Enriched with Olive Oil Exerts Greater Effects on Cardiovascular Disease Risk Factors than Raw Tomato and Tomato Sauce: A Randomized Trial

by Palmira Valderas-Martinez, Gemma Chiva-Blanch, Rosa Casas, Sara Arranz, Miriam Martínez-Huélamo, Mireia Urpi-Sarda, Xavier Torrado, Dolores Corella, Rosa M. Lamuela-Raventós and Ramon Estruch

Nutrients 2016, 8(3), 170; doi:10.3390/nu8030170

Received: 15 December 2015 / Revised: 4 March 2016 / Accepted: 10 March 2016 / Published: 16 March 2016

Abstract

Epidemiological studies have observed a negative association between tomato intake and the incidence of cardiovascular disease. As tomato sauces are usually cooked with the addition of oil, some studies have pointed out that both processes may increase the bioavailability of the bioactive compounds.

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Epidemiological studies have observed a negative association between tomato intake and the incidence of cardiovascular disease. As tomato sauces are usually cooked with the addition of oil, some studies have pointed out that both processes may increase the bioavailability of the bioactive compounds. However, the effect of consumption of raw tomatoes and tomato sauces on inflammation biomarkers and adhesion molecules related to atherosclerosis remains unknown. The aim of this study was to test the postprandial effects of a single dose of raw tomatoes (RT), tomato sauce (TS) and tomato sauce with refined olive oil (TSOO) on cardiovascular disease risk factors. We performed an open, prospective, randomized, cross-over, controlled feeding trial in 40 healthy subjects who randomly received: 7.0 g of RT/kg of body weight (BW), 3.5 g of TS/kg BW, 3.5 g of TSOO/Kg BW and 0.25 g of sugar solved in water/kg BW on a single occasion on four different days. Biochemical parameters and cellular and circulating inflammatory biomarkers were assessed at baseline and 6 h after each intervention. The results indicate that, compared to control intervention, a single tomato intake in any form decreased plasma total cholesterol, triglycerides and several cellular and plasma inflammatory biomarkers, and increased plasma high density lipoproteins (HDL) cholesterol and interleukine (IL) 10 concentrations. However, the changes of plasma IL-6 and vascular cell adhesion molecule-1 (VCAM-1), and lymphocyte function-associated antigen-1 (LFA-1) from T-lymphocytes and CD36 from monocytes were significantly greater after TSOO than after RT and TS interventions. We concluded that tomato intake has beneficial effects on cardiovascular risk factors, especially cooked and enriched with oil. Full article

(This article belongs to the Special Issue Flavonoids, Inflammation and Immune System)

Open AccessArticle Appropriate LDL-C-to-HDL-C Ratio Cutoffs for Categorization of Cardiovascular Disease Risk Factors among Uygur Adults in Xinjiang, China

by Qing-Jie Chen, Hong-Mei Lai, Bang-Dang Chen, Xiao-Mei Li, Hui Zhai, Chun-Hui He, Shuo Pan, Jun-Yi Luo, Jing Gao, Fen Liu, Yi-Tong Ma and Yi-Ning Yang

Int. J. Environ. Res. Public Health 2016, 13(2), 235; doi:10.3390/ijerph13020235

Received: 15 November 2015 / Revised: 2 February 2016 / Accepted: 14 February 2016 / Published: 19 February 2016

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Abstract

Elevated LDL-C/HDL-C ratio has been shown to be a marker of lipid metabolism as well as a good predictor of coronary artery disease (CAD). Thus, the aim of this study was to investigate whether the LDL-C/HDL-C ratio is useful for detecting cardiovascular disease

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Elevated LDL-C/HDL-C ratio has been shown to be a marker of lipid metabolism as well as a good predictor of coronary artery disease (CAD). Thus, the aim of this study was to investigate whether the LDL-C/HDL-C ratio is useful for detecting cardiovascular disease (CVD) risk factors in general healthy Uygur adults in Xinjiang. A total of 4047 Uygur subjects aged ≥35 years were selected from the Cardiovascular Risk Survey (CRS) study which was carried out from October 2007 to March 2010. Anthropometric data, blood pressure, lipid profile and fasting glucose were measured in all participants. The prevalence, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each LDL-C/HDL-C ratio were calculated. The prevalence of high LDL-C and low HDL-C cholesterol was high and positively correlated with higher LDL-C/HDL-C ratio in the Uygur population. In both men and women, we detected a slight apparent trend of high prevalence of hypertension and hypercholesterolemia with higher LDL-C/HDL-C ratio. Our study also demonstrated that the discriminatory power of the LDL-C/HDL-C ratio for CVD risk factors was slightly stronger in men than in women. Analysis of the shortest distance in the ROC curves for hypertension, dyslipidemia, diabetes, or ≥two of these risk factors suggested a LDL-C/HDL-C ratio cutoff of 2.5 for both men and women. The results of this study showed that a LDL-C/HDL-C ratio cut-off of 2.5 might be used as the predictive marker to detect CVD risk factors among Uygur adults in Xinjiang. Full article

(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)

Open AccessFeature PaperReview Antioxidants and Cardiovascular Risk Factors

by Daniela Pellegrino

Diseases 2016, 4(1), 11; doi:10.3390/diseases4010011

Received: 15 December 2015 / Revised: 3 February 2016 / Accepted: 5 February 2016 / Published: 17 February 2016

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Abstract

Cardiovascular disease (CVD), the world’s primary cause of death and disability, represents a global health problem and involves a great public financial commitment in terms of both inability to work and pharmaceutical costs. CVD is characterized by a cluster of disorders, associated with

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Cardiovascular disease (CVD), the world’s primary cause of death and disability, represents a global health problem and involves a great public financial commitment in terms of both inability to work and pharmaceutical costs. CVD is characterized by a cluster of disorders, associated with complex interactions between multiple risk factors. The early identification of high cardiovascular risk subjects is one of the main targets of primary prevention in order to reduce the adverse impact of modifiable factors, from lifestyle changes to pharmacological treatments. The cardioprotective effect of food antioxidants is well known. Indeed, a diet rich in fruits and vegetables results in an increase in serum antioxidant capacity and a decrease in oxidative stress. In contrast, studies on antioxidant supplementation, even those that are numerically significant, have revealed no clear benefit in prevention and therapy of CVD. Both short- and long-term clinical trials have failed to consistently support cardioprotective effects of supplemental antioxidant intake. The aim of this review is to evaluate the antioxidant effects on the main cardiovascular risk factors including hypertension, dyslipidemia, diabetes. Full article

(This article belongs to the collection Effects of Food Antioxidants on Cardiovascular Diseases and Human Cancers)

Open AccessArticle Resveratrol Supplementation in Schizophrenia Patients: A Randomized Clinical Trial Evaluating Serum Glucose and Cardiovascular Risk Factors

by Karine Zortea, Viviane C. Franco, Lenise P. Francesconi, Keila M. M. Cereser, Maria Inês R. Lobato and Paulo S. Belmonte-de-Abreu

Nutrients 2016, 8(2), 73; doi:10.3390/nu8020073

Received: 27 October 2015 / Revised: 22 December 2015 / Accepted: 20 January 2016 / Published: 29 January 2016

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Abstract

Background: Patients with schizophrenia (SZ) are generally overweight or obese and have several metabolic disorders. Additionally, such patients have a lower life expectancy and the main cause of their increased mortality is cardiovascular disease (CVD). The objective of this study was to determine

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Background: Patients with schizophrenia (SZ) are generally overweight or obese and have several metabolic disorders. Additionally, such patients have a lower life expectancy and the main cause of their increased mortality is cardiovascular disease (CVD). The objective of this study was to determine the efficacy of resveratrol supplementation on serum glucose and CVD risk factors in individuals with SZ. Methods and Results: This is a four-week randomized, double-blind controlled trial (registration No.: NCT 02062190) in which 19 men with a diagnosis of SZ, aged 18 to 65, were assigned to either a resveratrol supplement group (200 mg/day) or a placebo group (200 mg/day). In short, we did not observe significant changes after resveratrol supplementation. In the placebo group, we found a significant increase in total cholesterol levels (p = 0.024) and in LDL-cholesterol (p = 0.002), as well as a decrease in body fat percentage (p = 0.038). The placebo group also showed an increase in triglycerides (9.19%) and a reduction in HDL-cholesterol (4.88%). In the resveratrol group, triglycerides decreased (7.64%). Conclusion: In summary, oral resveratrol in reasonably low dosages (200 mg daily) brought no differences to body weight, waist circumference, glucose, and total cholesterol. It was possible to note that the lipid profile in the placebo group worsened and, although no significant differences were found, we can assume that resveratrol might prevent lipid profile damage and that the intervention affected the lipoprotein metabolism at various levels. Full article

(This article belongs to the Special Issue Selected Papers from Resveratrol Regional Meeting 2015)

Open AccessArticle Risk Factors for Cardiovascular Disease and Their Clustering among Adults in Jilin (China)

by Jianxing Yu, Yonghui Ma, Sen Yang, Kai Pang, Yaqin Yu, Yuchun Tao and Lina Jin

Int. J. Environ. Res. Public Health 2016, 13(1), 70; doi:10.3390/ijerph13010070

Received: 21 October 2015 / Revised: 16 December 2015 / Accepted: 17 December 2015 / Published: 23 December 2015

Abstract

Background: Clustering of cardiovascular disease (CVD) risk factors constitutes a major public health challenge. Although a number of researchers have investigated the CVD risk factor clusters in China, little is known about the related prevalence and clustering associated with demographics in Jilin

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Background: Clustering of cardiovascular disease (CVD) risk factors constitutes a major public health challenge. Although a number of researchers have investigated the CVD risk factor clusters in China, little is known about the related prevalence and clustering associated with demographics in Jilin Province in China; this study aims to reveal that relationship. Methods: A cross-sectional survey based on a sample of 16,834 adults aged 18 to 79 years was conducted in Jilin in 2012. The prevalence and clustering of CVD risk factors were analysed through complex weighted computation. Quantitative variables were compared by the t test, and categorical variables were compared by the Rao-Scott-χ² test. Finally, multivariable logistic regression analysis was used to evaluate the CVD risk factor clusters associated with demographics. Results: The prevalences of hypertension, diabetes, dyslipidemia, overweight and smoking were 37.3%, 8.2%, 36.8%, 47.3%, and 31.0%, respectively, and these risk factors were associated with gender, education level, age, occupation and family income (p < 0.05). Overall, compared with females, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors clusters in males were 3.70 (95%CI 3.26 to 4.20), 4.66 (95%CI 4.09 to 5.31), and 5.76 (95%CI 5.01 to 6.63), respectively. In particular, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors increased with age. Conclusions: CVD risk factor clusters are common among adults in northeast China, and they constitute a major public health challenge. More effective attention and interventions should be directed toward the elderly and toward persons with lower incomes and low levels of education. Full article

Open AccessArticle Concord Grape Juice Polyphenols and Cardiovascular Risk Factors: Dose-Response Relationships

by Jeffrey B. Blumberg, Joseph A. Vita and C. -Y. Oliver Chen

Nutrients 2015, 7(12), 10032-10052; doi:10.3390/nu7125519

Received: 10 October 2015 / Revised: 9 November 2015 / Accepted: 23 November 2015 / Published: 2 December 2015

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Abstract

Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice

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Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice flavonoids to these outcomes. Utilizing the results of clinical trials testing single doses, we have analyzed data from studies of 100% Concord grape juice by placing its flavonoid content in the context of results from randomized clinical trials of other polyphenol-rich foods and beverages describing the same outcomes but covering a broader range of intake. We selected established biomarkers determined by similar methods for measuring flow-mediated vasodilation (FMD), blood pressure, platelet aggregation, and the resistance of low density lipoprotein cholesterol (LDL) to oxidation. Despite differences among the clinical trials in the treatment, subjects, and duration, correlations were observed between the dose and FMD. Inverse dose-response relationships, albeit with lower correlation coefficients, were also noted for the other outcomes. These results suggest a clear relationship between consumption of even modest serving sizes of Concord grape juice, flavonoid intake, and effects on risk factors for cardiovascular disease. This approach to dose-response relationships may prove useful for testing other individual foods and beverages. Full article

Open AccessReview Cardiovascular Complications of Pregnancy

by Maria Carolina Gongora and Nanette K. Wenger

Int. J. Mol. Sci. 2015, 16(10), 23905-23928; doi:10.3390/ijms161023905

Received: 15 June 2015 / Revised: 17 September 2015 / Accepted: 21 September 2015 / Published: 9 October 2015

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Abstract

Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary

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Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up. Full article

(This article belongs to the Special Issue Prediction, Diagnostics and Prevention of Pregnancy Complications)

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Open AccessArticle Association of Nut Consumption with Cardiometabolic Risk Factors in the 2008/2009 New Zealand Adult Nutrition Survey

by Rachel C. Brown, Siew Ling Tey, Andrew R. Gray, Alexandra Chisholm, Claire Smith, Elizabeth Fleming and Winsome Parnell

Nutrients 2015, 7(9), 7523-7542; doi:10.3390/nu7095351

Received: 20 July 2015 / Revised: 12 August 2015 / Accepted: 21 August 2015 / Published: 8 September 2015

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Abstract

Nut consumption has been associated with improvements in risk factors for chronic disease in populations within North America, Europe and Iran. This relationship has not been investigated in New Zealand (NZ). The associations between nut consumption and cardiometabolic risk factors among New Zealanders

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Nut consumption has been associated with improvements in risk factors for chronic disease in populations within North America, Europe and Iran. This relationship has not been investigated in New Zealand (NZ). The associations between nut consumption and cardiometabolic risk factors among New Zealanders were examined. Data from the 24-h diet recalls of 4721 participants from the NZ Adult Nutrition Survey 2008/2009 (2008/2009 NZANS) were used to determine whole and total nut intake. Anthropometric data and blood pressure were collected, as well as blood samples analysed for total cholesterol (total-C) and HDL cholesterol (HDL-C), glycated haemoglobin (HbA1c), C-reactive protein (CRP) and folate. Participants were classified according to their five-year cardiovascular disease (CVD) risk. Both whole and total nut consumers had significantly lower weight, body mass index (BMI), waist circumference and central adiposity than non-nut consumers (all p ≤ 0.044). Whole blood, serum and red blood cell folate concentrations were significantly higher among whole nut consumers compared to non-whole nut consumers (all p ≤ 0.014), with only serum folate higher in total nut consumers compared to non-total nut consumers (p = 0.023). There were no significant differences for blood pressure, total-C, HDL-C and HbA1c; however, significant negative associations between total nut consumption and CVD risk category (p < 0.001) and CRP (p = 0.045) were apparent. Nut consumption was associated with more favourable body composition and a number of risk factors, which could collectively reduce chronic disease. Full article

(This article belongs to the Special Issue Dietary Pattern and Health)

Open AccessArticle Effects of n-3 Polyunsaturated Fatty Acids (ω-3) Supplementation on Some Cardiovascular Risk Factors with a Ketogenic Mediterranean Diet

by Antonio Paoli, Tatiana Moro, Gerardo Bosco, Antonino Bianco, Keith A. Grimaldi, Enrico Camporesi and Devanand Mangar

Mar. Drugs 2015, 13(2), 996-1009; doi:10.3390/md13020996

Received: 9 October 2014 / Revised: 27 January 2015 / Accepted: 6 February 2015 / Published: 13 February 2015

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Abstract

Background: the ketogenic diet (KD) has become a widely used nutritional approach for weight loss. Some of the KD’s positive effects on metabolism and cardiovascular risk factors are similar to those seen after n-3 polyunsaturated fatty acids (ω-3) supplementation. We hypothesized that

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Background: the ketogenic diet (KD) has become a widely used nutritional approach for weight loss. Some of the KD’s positive effects on metabolism and cardiovascular risk factors are similar to those seen after n-3 polyunsaturated fatty acids (ω-3) supplementation. We hypothesized that a ketogenic Mediterranean diet with phytoextracts combined with ω-3 supplementation may have increased positive effects on cardiovascular risk factors and inflammation. Methods: We analyzed 34 male overweight subjects; aged between 25 and 65 years who were overall healthy apart from overweight. The subjects followed a ketogenic diet protocol for four weeks; with (KDO3) or without (KD) ω-3 supplementation. Results: All subjects experienced a significant loss of body weight and body fat and there was no significant differences between treatment (body weight: KD—4.7 kg, KDO3—4.03 kg, body fat KD—5.41 kg, KDO3—5.86 kg). There were also significant decreases in total cholesterol, LDL-c, and glucose levels. Triglycerides and insulin levels decreased more in KDO3 vs. KD subjects, with a significant difference. All the investigated inflammatory cytokines (IL-1β, IL-6, TNF-α) decreased significantly in KDO3 subjects whilst only TNF-α showed a significant decrease in KD subjects over the 12 month study period. No significant changes were observed in anti-inflammatory cytokines (IL-10 and IL-1Ra), creatinine, urea and uric acid. Adiponectin increased significantly only in the KDO3 group. Conclusions: ω-3 supplementation improved the positive effects of a ketogenic Mediterranean diet with phytoextracts on some cardiovascular/metabolic risk factors and inflammatory state. Full article

(This article belongs to the Special Issue Marine Functional Food Products - Cardiovascular Diseases)

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Open AccessReview Post-Traumatic Stress Disorder among Cardiac Patients: Prevalence, Risk Factors, and Considerations for Assessment and Treatment

by Heather Tulloch, Paul S. Greenman and Vanessa Tassé

Behav. Sci. 2015, 5(1), 27-40; doi:10.3390/bs5010027

Received: 30 September 2014 / Accepted: 2 December 2014 / Published: 23 December 2014

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Abstract

There is increasing awareness of the impact of post-traumatic stress disorder (PTSD) on physical health, particularly cardiovascular disease. We review the literature on the role of trauma in the development of cardiovascular risk factors and disease, aftermath of a cardiac event, and risk

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There is increasing awareness of the impact of post-traumatic stress disorder (PTSD) on physical health, particularly cardiovascular disease. We review the literature on the role of trauma in the development of cardiovascular risk factors and disease, aftermath of a cardiac event, and risk for recurrence in cardiac patients. We explore possible mechanisms to explain these relationships, as well as appropriate assessment and treatment strategies for this population. Our main conclusion is that screening and referral for appropriate treatments are important given the high prevalence rates of PTSD in cardiac populations and the associated impact on morbidity and mortality. Full article

(This article belongs to the Special Issue Post-traumatic Stress Disorder: Assessment and Treatment Considerations)

Open AccessArticle Dietary Fructose Reduction Improves Markers of Cardiovascular Disease Risk in Hispanic-American Adolescents with NAFLD

by Ran Jin, Jean A. Welsh, Ngoc-Anh Le, Jeffrey Holzberg, Puneet Sharma, Diego R. Martin and Miriam B. Vos

Nutrients 2014, 6(8), 3187-3201; doi:10.3390/nu6083187

Received: 6 June 2014 / Revised: 13 July 2014 / Accepted: 30 July 2014 / Published: 8 August 2014

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is now thought to be the most common liver disease worldwide. Cardiovascular complications are a leading cause of mortality in NAFLD. Fructose, a common nutrient in the westernized diet, has been reported to be associated with increased cardiovascular

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Nonalcoholic fatty liver disease (NAFLD) is now thought to be the most common liver disease worldwide. Cardiovascular complications are a leading cause of mortality in NAFLD. Fructose, a common nutrient in the westernized diet, has been reported to be associated with increased cardiovascular risk, but its impact on adolescents with NAFLD is not well understood. We designed a 4-week randomized, controlled, double-blinded beverage intervention study. Twenty-four overweight Hispanic-American adolescents who had hepatic fat >8% on imaging and who were regular consumers of sweet beverages were enrolled and randomized to calorie-matched study-provided fructose only or glucose only beverages. After 4 weeks, there was no significant change in hepatic fat or body weight in either group. In the glucose beverage group there was significantly improved adipose insulin sensitivity, high sensitivity C-reactive protein (hs-CRP), and low-density lipoprotein (LDL) oxidation. These findings demonstrate that reduction of fructose improves several important factors related to cardiovascular disease despite a lack of measurable improvement in hepatic steatosis. Reducing dietary fructose may be an effective intervention to blunt atherosclerosis progression among NAFLD patients and should be evaluated in longer term clinical trials. Full article

(This article belongs to the Special Issue Nutrition and Liver Disease)

Open AccessArticle Dietary Intake Is Related to Multifactor Cardiovascular Risk Score in Obese Boys

by Tracy L. Schumacher, Tracy L. Burrows, Dylan P. Cliff, Rachel A. Jones, Anthony D. Okely, Louise A. Baur, Philip J. Morgan, Robin Callister, May M. Boggess and Clare E. Collins

Healthcare 2014, 2(3), 282-298; doi:10.3390/healthcare2030282

Received: 5 February 2014 / Revised: 21 June 2014 / Accepted: 3 July 2014 / Published: 23 July 2014

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Abstract

Cardiovascular disease (CVD) originates in childhood and early identification of risk factors provides an early intervention opportunity. The aim was to identify children at higher risk using a CVD risk score, developed from factors known to cluster in childhood. Risk was scored as

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Cardiovascular disease (CVD) originates in childhood and early identification of risk factors provides an early intervention opportunity. The aim was to identify children at higher risk using a CVD risk score, developed from factors known to cluster in childhood. Risk was scored as very high (≥97.5th centile), high (≥95th), moderate (≥90th) or threshold (<90th) using normal pediatric reference ranges for 10 common biomedical risk factors. These were summed in a multifactor CVD risk score and applied to a sample of 285 observations from 136 overweight Australian children (41% male, aged 7–12 years). Strength of associations between CVD risk score and individual biomedical and dietary variables were assessed using univariate logistic regression. High waist circumference (Odds Ratio: 5.48 [95% CI: 2.60–11.55]), body mass index (OR: 3.22 [1.98–5.26]), serum insulin (OR: 3.37 [2.56–4.42]) and triglycerides (OR: 3.02 [2.22–4.12]) were all significantly related to CVD risk score. High intakes of total fat (OR: 4.44 [1.19–16.60]), sugar (OR: 2.82 [1.54–5.15]) and carbohydrate (OR 1.75 [1.11–2.77]) were significantly related to CVD risk score in boys only. This multifactor CVD risk score could be a useful tool for researchers to identify elevated risk in children. Further research is warranted to examine sex-specific dietary factors related to CVD risk in children. Full article

(This article belongs to the Special Issue The Close Relationship: Health and Nutrition)

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Open AccessArticle Risk-Adjusted Survival after Coronary Artery Bypass Grafting: Implications for Quality Improvement

by Jimmy T. Efird, Wesley T. O'Neal, Stephen W. Davies, Jason B. O'Neal, Linda C. Kindell, Curtis A. Anderson, W. Randolph Chitwood, T. Bruce Ferguson and Alan P. Kypson

Int. J. Environ. Res. Public Health 2014, 11(7), 7470-7481; doi:10.3390/ijerph110707470

Received: 10 December 2013 / Revised: 28 March 2014 / Accepted: 28 March 2014 / Published: 21 July 2014

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Abstract

Mortality represents an important outcome measure following coronary artery bypass grafting. Shorter survival times may reflect poor surgical quality and an increased number of costly postoperative complications. Quality control efforts aimed at increasing survival times may be misleading if not properly adjusted for

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Mortality represents an important outcome measure following coronary artery bypass grafting. Shorter survival times may reflect poor surgical quality and an increased number of costly postoperative complications. Quality control efforts aimed at increasing survival times may be misleading if not properly adjusted for case-mix severity. This paper demonstrates how to construct and cross-validate efficiency-outcome plots for a specified time (e.g., 6-month and 1-year survival) after coronary artery bypass grafting, accounting for baseline cardiovascular risk factors. The application of this approach to regional centers allows for the localization of risk stratification rather than applying overly broad and non-specific models to their patient populations. Full article

(This article belongs to the Special Issue Proceedings from the Tenth International Symposium on Recent Advances in Environmental Health Research)

Open AccessArticle Relationship between Obesity, Adipocytokines and Inflammatory Markers in Type 2 Diabetes: Relevance for Cardiovascular Risk Prevention

by Natasa Rajkovic, Miroslava Zamaklar, Katarina Lalic, Aleksandra Jotic, Ljiljana Lukic, Tanja Milicic, Sandra Singh, Ljubica Stosic and Nebojsa M. Lalic

Int. J. Environ. Res. Public Health 2014, 11(4), 4049-4065; doi:10.3390/ijerph110404049

Received: 14 January 2014 / Revised: 20 March 2014 / Accepted: 31 March 2014 / Published: 14 April 2014

Cited by 17 | Viewed by 2022 | PDF Full-text (352 KB) | HTML Full-text | XML Full-text

Abstract

This study aimed to analyse the impact of obesity in type 2 diabetes (T2D) on adipocytokines (adiponectin, leptin and resistin) and inflammatory markers (TNF-α, IL-6 and hsCRP) as cardiovascular risk factors. A cross-sectional study comparing the basal levels of adipocytokines and inflammatory markers

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This study aimed to analyse the impact of obesity in type 2 diabetes (T2D) on adipocytokines (adiponectin, leptin and resistin) and inflammatory markers (TNF-α, IL-6 and hsCRP) as cardiovascular risk factors. A cross-sectional study comparing the basal levels of adipocytokines and inflammatory markers was done in 18 obese (BMI ≥ 30 kg/m²) (group A), 21 overweight (25 kg/m²≤ BMI < 30 kg/m²) (group B), 25 non-obese T2D patients (group C) and 15 non-obese controls (group D). The lowest levels of adiponectin and the highest levels of leptin, resistin, TNF-α, IL-6 and hsCRP were found in group A. Adiponectin levels were significantly lower, and resistin, TNF-α, and hsCRP levels were elevated in group C vs. D. However, leptin and IL-6 levels differed significantly between groups A and B, but not between groups C and D. Moreover, we found a significant negative correlation between adiponectin and TNF-α, but not with other markers, which was independent of the presence of obesity. In contrast, leptin and resistin correlated with the inflammatory markers, and this correlation was obesity-dependent. Our results suggest that obesity influences cardiovascular risk primarily through changes in leptin and resistin and less efficiently at the level of adiponectin. Full article

Open AccessArticle Dietary Pattern and Its Association with the Prevalence of Obesity, Hypertension and Other Cardiovascular Risk Factors among Chinese Older Adults

by Jing Sun, Nicholas J. Buys and Andrew P. Hills

Int. J. Environ. Res. Public Health 2014, 11(4), 3956-3971; doi:10.3390/ijerph110403956

Received: 27 February 2014 / Revised: 31 March 2014 / Accepted: 1 April 2014 / Published: 10 April 2014

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Abstract

Aim: This article examined the association between dietary patterns and cardiovascular risk factors in Chinese older adults. Methods: For this study, older adults with one or more cardiovascular risk factors or a history of cardiovascular disease were randomly selected using health

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Aim: This article examined the association between dietary patterns and cardiovascular risk factors in Chinese older adults. Methods: For this study, older adults with one or more cardiovascular risk factors or a history of cardiovascular disease were randomly selected using health check medical records from the Changshu and Beijing Fangshan Centers for Disease Control and Prevention. Exploratory factor analysis and cluster analysis was used to extract dietary pattern factors. Log binomial regression analysis was used to analyse the association between dietary patterns and chronic disease related risk factors. Results: Four factors were found through factor analysis. A high level of internal consistency was obtained, with a high Cronbach’s alpha coefficient of 0.83. Cluster analysis identified three dietary patterns: healthy diet, Western diet, and balanced diet. Findings in this sample of Chinese adults correspond to those reported in previous studies, indicating that a Western diet is significantly related to likelihood of having obesity, hypertension and the metabolic syndrome. The identification of distinct dietary patterns among Chinese older adults and the nutritional status of people with chronic diseases suggest that the three dietary patterns have a reasonable level of discriminant validity. Conclusions: This study provides evidence that a FFQ is a valid and reliable tool to assess the dietary patterns of individuals with chronic diseases in small- to medium-size urban and rural settings in China. It also validates the significant association between dietary pattern and cardiovascular disease risk factors, including body mass index, blood pressure, triglycerides, and metabolic conditions. Clinical diagnosis of chronic disease further confirmed this relationship in Chinese older adults. Full article

(This article belongs to the Special Issue IJERPH: 10th Anniversary)

Open AccessArticle Risk Factors of CVD Mortality among the Elderly in Beijing, 1992 – 2009: An 18-year Cohort Study

by Tao Zhou, Xia Li, Zhe Tang, Changchun Xie, Lixin Tao, Lei Pan, Da Huo, Fei Sun, Yanxia Luo, Wei Wang, Aoshuang Yan and Xiuhua Guo

Int. J. Environ. Res. Public Health 2014, 11(2), 2193-2208; doi:10.3390/ijerph110202193

Received: 11 November 2013 / Revised: 14 January 2014 / Accepted: 21 January 2014 / Published: 21 February 2014

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Abstract

Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data

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Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data mining of the Beijing Longitudinal Study of Aging (BLSA). BLSA is a representative cohort study from 1992 to 2009, hosted by Xuan Wu Hospital. Competing risk survival analysis was conducted to explore the association between risk factors and CVD mortality. The factors focused mainly on lifestyle, physical condition, and the model was adjusted for age and gender. There were 273 of the 1,068 recorded deaths caused by CVD among the 2010 participants. Living in a suburban area (HR = 0.614, 95% CI: 0.410-0.921) was associated with lower CVD mortality. Increasing age (66–75: HR = 1.511, 95% CI: 1.111–2.055; ≥76: HR = 1.847, 95% CI: 1.256–2.717), high blood pressure (HR = 1.407, 95% CI: 1.031–1.920), frequent consumption of meat (HR = 1.559, 95% CI: 1.079–2.254) and physical inactivity (p = 0.046) were associated with higher CVD mortality. The study provides an instructional foundation for the control and prevention of CVD in Beijing, China. Full article

Open AccessReview Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review

by Vasilios G. Athyros, Andromachi Reklou, Antonis Lazarides, Eudoxia Mitsiou and Asterios Karagiannis

Diseases 2013, 1(1), 51-72; doi:10.3390/diseases1010051

Received: 20 June 2013 / Revised: 9 November 2013 / Accepted: 14 November 2013 / Published: 20 November 2013

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Abstract

The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS) or not, substantially increases the risk of cardiovascular disease (CVD) and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS), and

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The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS) or not, substantially increases the risk of cardiovascular disease (CVD) and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS), and in high central aortic blood pressure (CABP), which are significant and independent CVD risk factors. Arterial hypertension was connected to AS long ago; however, other MetS components (obesity, dyslipidaemia, dysglycaemia) or MetS associated abnormalities not included in MetS diagnostic criteria (renal dysfunction, hyperuricaemia, hypercoaglutability, menopause, non alcoholic fatty liver disease, and obstructive sleep apnea) have been implicated too. We discuss the evidence connecting these cardio-metabolic risk factors, which negatively affect AS and finally increase CVD risk. Furthermore, we discuss the impact of possible lifestyle and pharmacological interventions on all these cardio-metabolic risk factors, in an effort to reduce CVD risk and identify features that should be taken into consideration when treating MetS patients with or without arterial hypertension. Full article

(This article belongs to the Special Issue Feature Papers)

Open AccessArticle Association of Metabolic Syndrome and Albuminuria with Cardiovascular Risk in Occupational Drivers

by Szu-Chia Chen, Jer-Ming Chang, Ming-Yen Lin, Meng-Ling Hou, Jer-Chia Tsai, Shang-Jyh Hwang and Hung-Chun Chen

Int. J. Mol. Sci. 2013, 14(11), 21997-22010; doi:10.3390/ijms141121997

Received: 29 July 2013 / Revised: 25 October 2013 / Accepted: 29 October 2013 / Published: 6 November 2013

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Abstract

Background and Aim: Metabolic syndrome (MetS) and albuminuria increase cardiovascular risk. However, in occupational drivers, the clinical significance of albuminuria and its association with MetS remain unclear. We investigated the prevalence of MetS, albuminuria and cardiovascular risk, and its associated risk factors

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Background and Aim: Metabolic syndrome (MetS) and albuminuria increase cardiovascular risk. However, in occupational drivers, the clinical significance of albuminuria and its association with MetS remain unclear. We investigated the prevalence of MetS, albuminuria and cardiovascular risk, and its associated risk factors in occupational drivers; Methods: 441 occupational drivers and 432 age- and sex-stratified matched counterpart controls were enrolled. MetS was defined using Adult Treatment Panel III for Asians. Albuminuria was defined as urine albumin-to-creatinine ratio ≥ 30 mg/g. Cardiovascular disease risk was evaluated by Framingham Risk Score (FRS); Results: A significantly higher prevalence of MetS (43.1% vs. 25.5%, p < 0.001), albuminuria (12.0% vs. 5.6%, p = 0.001) and high FRS risk ≥ 10% of 10-year risk (46.9% vs. 35.2%, p < 0.001) was found in occupational drivers compared with their counterpart controls. Multiple logistic regression analysis showed that old age, a history of diabetes, gout and betel nut chewing, less exercise and albuminuria (odds ratio [OR], 2.75; p = 0.01) were risk factors for MetS, while a history of renal disease, diabetes and hypertension, and MetS (OR, 2.28; p = 0.01) were risk factors for albuminuria in occupational drivers; Conclusions: Our study demonstrated that MetS and albuminuria were public health problems in occupational drivers. An education program for promoting healthy lifestyle and a regular occupational health visit for early detection and interventions should be established. Full article

Open AccessReview Vitamin D and Cardiovascular Disease

by Katharina Kienreich, Andreas Tomaschitz, Nicolas Verheyen, Thomas Pieber, Martin Gaksch, Martin R. Grübler and Stefan Pilz

Nutrients 2013, 5(8), 3005-3021; doi:10.3390/nu5083005

Received: 7 May 2013 / Revised: 25 June 2013 / Accepted: 23 July 2013 / Published: 31 July 2013

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Abstract

Vitamin D deficiency, as well as cardiovascular diseases (CVD) and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a

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Vitamin D deficiency, as well as cardiovascular diseases (CVD) and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk factors: hypertension, obesity and dyslipidemia, type 2 diabetes, chronic kidney disease and endothelial dysfunction. In addition, we outline the most recent observational, as well as interventional data on the influence of vitamin D on CVD. Since it is still an unresolved issue whether vitamin D deficiency is causally involved in the pathogenesis of CVD, data from randomized controlled trials (RCTs) designed to assess the impact of vitamin D supplementation on cardiovascular outcomes are awaited with anticipation. At present, we can only conclude that vitamin D deficiency is an independent cardiovascular risk factor, but whether vitamin D supplementation can significantly improve cardiovascular outcomes is still largely unknown. Full article

(This article belongs to the Special Issue Nutrition and Cardiovascular Diseases)

Open AccessArticle Analysis of Various Subsets of Circulating Mononuclear Cells in Asymptomatic Coronary Artery Disease

by Alexander E. Berezin and Alexander A. Kremzer

J. Clin. Med. 2013, 2(3), 32-44; doi:10.3390/jcm2030032

Received: 3 June 2013 / Revised: 11 July 2013 / Accepted: 20 July 2013 / Published: 30 July 2013

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Abstract

The objective of this study was to evaluate the correlation between multiple cardiovascular risk factors (MCRFs) and circulating mononuclear cells (CMCs) in asymptomatic coronary artery disease patients. Design and Methods: 126 subjects (54 male), aged 48 to 62 years, with asymptomatic coronary artery

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The objective of this study was to evaluate the correlation between multiple cardiovascular risk factors (MCRFs) and circulating mononuclear cells (CMCs) in asymptomatic coronary artery disease patients. Design and Methods: 126 subjects (54 male), aged 48 to 62 years, with asymptomatic coronary artery disease (CAD) documented previously with angiography, and 25 healthy volunteers were enrolled in the study. The flow cytometric technique was used for predictably distinguishing cell subsets that depend on the expression of CD14, CD34, Tie-2, CD45, and CD309 (VEGFR2). Results: The analysis of the outcome obtained shows a trend of an increase in circulating CD45⁻CD34⁺ CMCs and a reduction in CMC population defined as CD14⁺CD309⁺ and CD14⁺CD309⁺Tie²⁺ in known asymptomatic CAD patients in comparison with healthy volunteers. Substantial correlations between CD45⁻CD34⁺ and conventional cardiovascular risk factors (hs-CRP, T2DM, serum uric acid and hypertension) were found in the patient cohort. The concentrations of CD14⁺CD309⁺ and CD14⁺CD309⁺Tie²⁺ CMCs had effect on such factors as T2DM (RR = 1.21; 95% CI = 1.10–1.40; p = 0.008), hs-CRP > 2.54 mg/L (RR = 1.29; 95% CI = 1.12–1.58; p = 0.006), Agatston score index (RR = 1.20; 95% CI = 1.15–1.27; p = 0.034), and occurrence of three and more cardiovascular risk factors (RR = 1.31; 95% CI = 1.12–1.49; p = 0.008). Conclusion: It is postulated that the reduction in circulating CD14⁺CD309⁺ and CD14⁺CD309⁺Tei²⁺ CMCs is related to a number of cardiovascular risk factors in asymptomatic patients with known CAD. Full article

Open AccessReview Effect of Diets Differing in Glycemic Index and Glycemic Load on Cardiovascular Risk Factors: Review of Randomized Controlled-Feeding Trials

by Aleksandra S. Kristo, Nirupa R. Matthan and Alice H. Lichtenstein

Nutrients 2013, 5(4), 1071-1080; doi:10.3390/nu5041071

Received: 6 February 2013 / Revised: 26 February 2013 / Accepted: 12 March 2013 / Published: 28 March 2013

Abstract

Despite a considerable amount of data available on the relationship between dietary glycemic index (GI) or load (GL) and cardiovascular disease (CVD) risk factors, in aggregate, the area remains unsettled. The aim of the present review was to summarize the effect of diets

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Despite a considerable amount of data available on the relationship between dietary glycemic index (GI) or load (GL) and cardiovascular disease (CVD) risk factors, in aggregate, the area remains unsettled. The aim of the present review was to summarize the effect of diets differing in GI/GL on CVD risk factors, by examining randomized controlled-feeding trials that provided all food and beverages to adult participants. The studies included a low and high GI/GL diet phase for a minimum of four weeks duration, and reported at least one outcome related to CVD risk; glucose homeostasis, lipid profile or inflammatory status. Ten publications representing five trials were identified. The low GI/GL compared to the high GI/GL diet unexpectedly resulted in significantly higher fasting glucose concentrations in two of the trials, and a lower area under the curve for glucose and insulin in one of the two studies during an oral glucose tolerance test. Response of plasma total, low density lipoprotein and high density lipoprotein cholesterol concentrations was conflicting in two of the studies for which data were available. There was either weak or no effect on inflammatory markers. The results of the five randomized controlled trials satisfying the inclusion criteria suggest inconsistent effects of the GI/GL value of the diet on CVD risk factors. Full article

(This article belongs to the Special Issue Nutrition and Cardiovascular Diseases)

Open AccessReview Asymmetric Dimethylarginine as a Surrogate Marker of Endothelial Dysfunction and Cardiovascular Risk in Patients with Systemic Rheumatic Diseases

by Theodoros Dimitroulas, Aamer Sandoo and George D. Kitas

Int. J. Mol. Sci. 2012, 13(10), 12315-12335; doi:10.3390/ijms131012315

Received: 20 August 2012 / Revised: 15 September 2012 / Accepted: 19 September 2012 / Published: 26 September 2012

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Abstract

The last few decades have witnessed an increased life expectancy of patients suffering with systemic rheumatic diseases, mainly due to improved management, advanced therapies and preventative measures. However, autoimmune disorders are associated with significantly enhanced cardiovascular morbidity and mortality not fully explained by

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The last few decades have witnessed an increased life expectancy of patients suffering with systemic rheumatic diseases, mainly due to improved management, advanced therapies and preventative measures. However, autoimmune disorders are associated with significantly enhanced cardiovascular morbidity and mortality not fully explained by traditional cardiovascular disease (CVD) risk factors. It has been suggested that interactions between high-grade systemic inflammation and the vasculature lead to endothelial dysfunction and atherosclerosis, which may account for the excess risk for CVD events in this population. Diminished nitric oxide synthesis—due to down regulation of endothelial nitric oxide synthase—appears to play a prominent role in the imbalance between vasoactive factors, the consequent impairment of the endothelial hemostasis and the early development of atherosclerosis. Asymmetric dimethylarginine (ADMA) is one of the most potent endogenous inhibitors of the three isoforms of nitric oxide synthase and it is a newly discovered risk factor in the setting of diseases associated with endothelial dysfunction and adverse cardiovascular events. In the context of systemic inflammatory disorders there is increasing evidence that ADMA contributes to the vascular changes and to endothelial cell abnormalities, as several studies have revealed derangement of nitric oxide/ADMA pathway in different disease subsets. In this article we discuss the role of endothelial dysfunction in patients with rheumatic diseases, with a specific focus on the nitric oxide/ADMA system and we provide an overview on the literature pertaining to ADMA as a surrogate marker of subclinical vascular disease. Full article

(This article belongs to the Special Issue ADMA and Nitrergic System)

Open AccessArticle Artificial Cold Air Increases the Cardiovascular Risks in Spontaneously Hypertensive Rats

by Bin Luo, Shuyu Zhang, Shoucun Ma, Ji Zhou and Baojian Wang

Int. J. Environ. Res. Public Health 2012, 9(9), 3197-3208; doi:10.3390/ijerph9093197

Received: 30 May 2012 / Revised: 21 July 2012 / Accepted: 28 August 2012 / Published: 4 September 2012

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Abstract

The purpose was to investigate the effects of artificial cold air on cardiovascular risk in hypertensive subjects. An artificial cold air was simulated with hourly ambient temperature data of a real moderate cold air in China. Twenty-four male SHR rats were randomly divided

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The purpose was to investigate the effects of artificial cold air on cardiovascular risk in hypertensive subjects. An artificial cold air was simulated with hourly ambient temperature data of a real moderate cold air in China. Twenty-four male SHR rats were randomly divided into the minimum temperature (Tmin) group, the rewarming temperature (Tr) group and two concurrent control groups with six rats in each (Tmin and Tr represent two cold air time points, respectively). Tmin and Tr groups were exposed to the cold air that was stopped at Tmin and Tr, respectively. After cold air exposure, blood pressure, heart rate and body weight were monitored, blood was collected for the detection of some indexes like fibrinogen, total cholesterol and uric acid. Results demonstrated that blood pressure, whole blood viscosity, blood fibrinogen, total cholesterol and uric acid increased significantly both in the Tmin and Tr groups; low density lipoprotein/high density lipoprotein increased significantly only in Tr group; there was higher level of blood fibrinogen in the Tr group than the Tmin group; higher levels of creatine kinase-MB was found in both the Tmin and Tr groups. These results suggest that cold air may increase the cardiovascular risks in hypertensive subjects indirectly through its effects on the sympathetic nervous system and renin angiotensin system, blood pressure and atherosclerosis risk factors like blood viscosity and fibrinogen, lipids and uric acid in the blood. Full article

Open AccessArticle Effects of Cold Air on Cardiovascular Disease Risk Factors in Rat

by Bin Luo, Shuyu Zhang, Shoucun Ma, Ji Zhou and Baojian Wang

Int. J. Environ. Res. Public Health 2012, 9(7), 2312-2325; doi:10.3390/ijerph9072312

Received: 16 May 2012 / Revised: 14 June 2012 / Accepted: 21 June 2012 / Published: 29 June 2012

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Abstract

The purpose of this study is to explore possible potential implications of cold air in cardiovascular disease (CVD) risk in rats. Healthy Wistar rats were exposed to artificial cold air under laboratory conditions, and their systolic blood pressure, heart rate, vasoconstriction, CVD risk

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The purpose of this study is to explore possible potential implications of cold air in cardiovascular disease (CVD) risk in rats. Healthy Wistar rats were exposed to artificial cold air under laboratory conditions, and their systolic blood pressure, heart rate, vasoconstriction, CVD risk factors, and myocardial damage indicators after cold air exposure were determined and evaluated. Systolic blood pressure, whole blood viscosity, and plasma level of norepinephrine, angiotensinⅡ, low density lipoprotein, total cholesterol, and fibrinogen in treatment groups increased significantly compared with control groups. No significant variations were found in plasma Mb and cTnT and myocardial tissue between the treatment and control groups. Results indicate that: (1) higher levels of SBP, WBV and LDL/HDL, total cholesterol (TC), and FG in blood may indicate higher CVD risks during cold air exposure; (2) cold air may exert continuous impacts on SBP and other CVD risk factors. Full article

Open AccessArticle Different Impacts of Cardiovascular Risk Factors on Oxidative Stress

by Maria L. Mansego, Josep Redon, Sergio Martinez-Hervas, Jose T. Real, Fernando Martinez, Sebastian Blesa, Veronica Gonzalez-Albert, Guillermo T. Saez, Rafael Carmena and Felipe J. Chaves

Int. J. Mol. Sci. 2011, 12(9), 6146-6163; doi:10.3390/ijms12096146

Received: 10 June 2011 / Revised: 1 September 2011 / Accepted: 7 September 2011 / Published: 20 September 2011

Abstract

The objective of the study was to evaluate oxidative stress (OS) status in subjects with different cardiovascular risk factors. With this in mind, we have studied three models of high cardiovascular risk: hypertension (HT) with and without metabolic syndrome, familial hypercholesterolemia (FH) and

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The objective of the study was to evaluate oxidative stress (OS) status in subjects with different cardiovascular risk factors. With this in mind, we have studied three models of high cardiovascular risk: hypertension (HT) with and without metabolic syndrome, familial hypercholesterolemia (FH) and familial combined hyperlipidemia (FCH) with and without insulin resistance. Oxidative stress markers (oxidized/reduced glutathione ratio, 8-oxo-deoxyguanosine and malondialdehide) together with the activity of antioxidant enzyme triad (superoxide dismutase, catalase, glutathione peroxidase) and activation of both pro-oxidant enzyme (NAPDH oxidase components) and AGTR1 genes, as well as antioxidant enzyme genes (CuZn-SOD, CAT, GPX1, GSR, GSS and TXN) were measured in mononuclear cells of controls (n = 20) and patients (n = 90) by assessing mRNA levels. Activity of some of these antioxidant enzymes was also tested. An increase in OS and pro-oxidant gene mRNA values was observed in patients compared to controls. The hypertensive group showed not only the highest OS values, but also the highest pro-oxidant activation compared to those observed in the other groups. In addition, in HT a significantly reduced antioxidant activity and mRNA induction of antioxidant genes were found when compared to controls and the other groups. In FH and FCH, the activation of pro-oxidant enzymes was also higher and antioxidant ones lower than in the control group, although it did not reach the values obtained in hypertensives. The thioredoxin system was more activated in patients as compared to controls, and the highest levels were in hypertensives. The increased oxidative status in the presence of cardiovascular risk factors is a consequence of both the activation of pro-oxidant mechanisms and the reduction of the antioxidant ones. The altered response of the main cytoplasmic antioxidant systems largely contributes to OS despite the apparent attempt of the thioredoxin system to control it. Full article

(This article belongs to the Special Issue Antioxidants)

Open AccessReview Nonsteroidal Anti-Inflammatory Drug-Induced Gastroduodenal Bleeding: Risk Factors and Prevention Strategies

by Marino Venerito, Thomas Wex and Peter Malfertheiner

Pharmaceuticals 2010, 3(7), 2225-2237; doi:10.3390/ph3072225

Received: 9 June 2010 / Revised: 6 July 2010 / Accepted: 14 July 2010 / Published: 14 July 2010

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Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely prescribed medications in the World. A frequent complication of NSAID use is gastroduodenal bleeding. Risk factors for gastroduodenal bleeding while on NSAID therapy are age, prior peptic ulcer and co-medication with anti-platelet agents, anticoagulants, glucocorticosteroids

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely prescribed medications in the World. A frequent complication of NSAID use is gastroduodenal bleeding. Risk factors for gastroduodenal bleeding while on NSAID therapy are age, prior peptic ulcer and co-medication with anti-platelet agents, anticoagulants, glucocorticosteroids and selective serotonin-reuptake inhibitors (SSRI). Prevention strategies for at-risk patients include the use of the lowest effective dose of NSAIDs, co-therapy with proton-pump inhibitors and/or the use of a COX-2 selective agent. Treatment of Helicobacter pylori infection is beneficial for primary prophylaxis of NSAID-induced gastroduodenal bleeding in NSAID-naive patients. For patients with cardiovascular risk factors requiring NSAIDs, naproxen should be selected. In very high risk patients for both gastrointestinal and cardiovascular complications NSAID therapy should be avoided altogether. Full article

(This article belongs to the Special Issue Non-Steroidal Anti-Inflammatory Drugs)

Open AccessArticle Two Distinct Training Methods for a Doctrine of Life with Healthy Heart in a Low Socioeconomic Society Model

by Selma Metintas, Cemalettin Kalyoncu and İnci Arıkan

Int. J. Environ. Res. Public Health 2009, 6(11), 2883-2897; doi:10.3390/ijerph6112883

Received: 3 September 2009 / Accepted: 17 November 2009 / Published: 19 November 2009

Cited by 1 | Viewed by 4797 | PDF Full-text (291 KB) | HTML Full-text | XML Full-text

Abstract

This study was conducted in three stages in a semi-rural region of Eskisehir, Turkey. In the first stage, individuals selected by random sampling were evaluated for cardiovascular disease risk factors. In the second stage, Group I and Group II training materials were randomly

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This study was conducted in three stages in a semi-rural region of Eskisehir, Turkey. In the first stage, individuals selected by random sampling were evaluated for cardiovascular disease risk factors. In the second stage, Group I and Group II training materials were randomly distributed. In the third stage, the subjects were screened one year later to assess and determine if there had been any changes in their attitudes towards the dangers of cardiovascular diseases. The number of active smokers significantly decreased after the training in the both groups. The percentage of people with regulated blood pressure exhibited an increase in Group II more than Group I. Full article

Open AccessArticle Agreement between the SCORE and D’Agostino Scales for the Classification of High Cardiovascular Risk in Sedentary Spanish Patients

by Manuel A. Gómez-Marcos, Gonzalo Grandes, José A. Iglesias-Valiente, Alvaro Sánchez, Imanol Montoya, Luis García-Ortiz and PEPAF Group

Int. J. Environ. Res. Public Health 2009, 6(11), 2800-2811; doi:10.3390/ijerph6112800

Received: 12 August 2009 / Accepted: 6 November 2009 / Published: 11 November 2009

Cited by 1 | Viewed by 6717 | PDF Full-text (465 KB) | HTML Full-text | XML Full-text

Abstract

Background: To evaluate agreement between cardiovascular risk in sedentary patients as estimated by the new Framingham-D’Agostino scale and by the SCORE chart, and to describe the patient characteristics associated with the observed disagreement between the scales. Design: A cross-sectional study was undertaken involving

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Background: To evaluate agreement between cardiovascular risk in sedentary patients as estimated by the new Framingham-D’Agostino scale and by the SCORE chart, and to describe the patient characteristics associated with the observed disagreement between the scales. Design: A cross-sectional study was undertaken involving a systematic sample of 2,295 sedentary individuals between 40–65 years of age seen for any reason in 56 primary care offices. An estimation was made of the Pearson correlation coefficient and kappa statistic for the classification of high risk subjects (≥20% according to the Framingham-D’Agostino scale, and ≥5% according to SCORE). Polytomous logistic regression models were fitted to identify the variables associated with the discordance between the two scales. Results: The mean risk in males (35%) was 19.5% ± 13% with D’Agostino scale, and 3.2% ± 3.3% with SCORE. Among females, they were 8.1% ± 6.8% and 1.2% ± 2.2%, respectively. The correlation between the two scales was 0.874 in males (95% CI: 0.857–0.889) and 0.818 in females (95% CI: 0.800–0.834), while the kappa index was 0.50 in males (95% CI: 0.44%–0.56%) and 0.61 in females (95% CI: 0.52%–0.71%). The most frequent disagreement, characterized by high risk according to D’Agostino scale but not according to SCORE, was much more prevalent among males and proved more probable with increasing age and increased LDL-cholesterol, triglyceride and systolic blood pressure values, as well as among those who used antihypertensive drugs and smokers. Conclusions: The quantitative correlation between the two scales is very high. Patient categorization as corresponding to high risk generates disagreements, mainly among males, where agreement between the two classifications is only moderate. Full article

(This article belongs to the Special Issue Cardiovascular Diseases and Public Health)

Open AccessArticle Factors Affecting Use of Preventive Tests for Cardiovascular Risk among Greeks

by Evelina Pappa, Nick Kontodimopoulos, Angelos A. Papadopoulos, Georgia Pallikarona, Dimitris Niakas and Yannis Tountas

Int. J. Environ. Res. Public Health 2009, 6(10), 2712-2724; doi:10.3390/ijerph6102712

Received: 26 August 2009 / Accepted: 19 October 2009 / Published: 23 October 2009

Cited by 7 | Viewed by 5149 | PDF Full-text (117 KB) | HTML Full-text | XML Full-text

Abstract

Data from a Greek national representative sample was used to investigate socio-demographic, self-perceived health, and health risk factors that determine the use of cardiovascular preventive tests (blood pressure, cholesterol and blood glucose). Chi-square and logistic regression analyses were used (p

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Data from a Greek national representative sample was used to investigate socio-demographic, self-perceived health, and health risk factors that determine the use of cardiovascular preventive tests (blood pressure, cholesterol and blood glucose). Chi-square and logistic regression analyses were used (p < 0.05). Older age, marriage, regular family doctor and chronic diseases increased the likelihood of receiving preventive tests, whereas low education and alcohol consumption reduced the likelihood of having these tests. The effect of obesity varied. Interventions which improve the knowledge of the poorly educated and empower the preventive role of the physicians may redress the inequalities and improve the effectiveness of preventive services utilization. Full article

(This article belongs to the Special Issue Health Behavior and Public Health)

Open AccessArticle Selenium Status and Cardiovascular Risk Profile in Healthy Adult Saudi Males

by Eman M. Alissa, Waqar H. Ahmed, Nabeel Al-ama and Gordon A. A. Ferns

Molecules 2009, 14(1), 141-159; doi:10.3390/molecules14010141

Received: 28 October 2008 / Revised: 8 December 2008 / Accepted: 8 December 2008 / Published: 31 December 2008

Cited by 5 | Viewed by 11472 | PDF Full-text (393 KB) | HTML Full-text | XML Full-text

Abstract

The purpose of this research was to investigate the relationship between selenium levels, thyroid function and other coronary risk factors in 140 Saudi subjects without overt coronary heart disease stratified by age. Demographic data and serum fasting lipid profile, glucose, thyroid function tests,

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The purpose of this research was to investigate the relationship between selenium levels, thyroid function and other coronary risk factors in 140 Saudi subjects without overt coronary heart disease stratified by age. Demographic data and serum fasting lipid profile, glucose, thyroid function tests, selenium status and dietary intake was assessed. The relationships between selenium status, thyroid function and cardiovascular risk factors were assessed by univariate and multivariate analysis. The results showed that thyroid hormone levels did not differ with age. Erythrocyte glutathione peroxidase (GPx) levels were significantly higher in the youngest vs. oldest tertile (p<0.0001). Selenium and iodine intake did not differ significantly with age tertile, but the average intake for the population sample was below the estimated average requirements for both elements. Serum lipoprotein (a) concentrations correlated with selenium (r = 0.417, p<0.0001) and TSH (r = 0.172, p<0.05). After adjustment for confounding variables; serum fT₄ and erythrocytes GPx remained significant determinants of serum TSH levels, whilst serum selenium and TSH were determinants of serum fT₄ levels. Serum Lp(a), a coronary risk factor, was strongly related to measures of selenium status. A significant relationship between measures of selenium status and thyroid function was found. Serum Lp(a) a known risk factor for cardiovascular disease was also related to selenium status in our population. Full article

(This article belongs to the Special Issue Selenium and Tellurium Chemistry)

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