Search Results (143)

Obesity is a multidimensional condition characterized by autonomic imbalance, metabolic inflexibility, impaired physical resilience, and ectopic adiposity, pathophysiological alterations that arise long before overt cardiometabolic disease becomes clinically detectable. Despite this, current cardiometabolic risk scores continue to rely predominantly on biochemical and anthropometric variables, such as BMI, waist circumference, glucose, and lipid levels. While these markers are practical, inexpensive, and validated across large population cohorts, growing evidence shows that they offer limited incremental predictive value and fail to capture early functional and structural abnormalities. The recent literature highlights the prognostic importance of autonomic dysfunction, reduced metabolic flexibility, diminished cardiorespiratory fitness, impaired muscular strength, and ectopic fat depots including visceral and epicardial adiposity, independently of the traditional anthropometric indices. The domains remain absent from traditional algorithms such as the Metabolic Syndrome criteria, the Framingham Risk Score, and SCORE2. As a result, cardiometabolic risk is frequently underestimated in key subgroups, including young adults with obesity, individuals with high visceral adiposity but normal BMI, those with subclinical myocardial dysfunction, and metabolically unhealthy normal-weight phenotypes. This narrative review synthesizes current evidence on obesity-related cardiometabolic impairment, highlights major gaps in established risk scores, and supports the conceptual development of the C.O.R.E. (Cardio-Obesity Risk Evaluation) Indicator Model—a hypothesis-generating, non-validated multidomain framework integrating autonomic, metabolic, functional, and structural markers to enable earlier risk phenotyping in future studies. Full article

Background: Diabetes can increase cardiovascular risk (CVR) through hyperglycemia and intestinal damage. The purpose of this study is to evaluate several intestinal permeability biomarkers in predicting CVR in patients with type 2 diabetes mellitus (T2DM). Methods: This study was conducted in 2024 with a total of 70 patients with T2DM, aged 19–64 years (32.9% men, 67.1% women). Socio-demographic data and health status were collected; Framingham Risk Score (FRS), anthropometric measures, and serum parameters (glucose, HbA1c, lipids, CRP, TNF-α, IL-6, trimetilamine-N-oxide (TMAO), zonulin, intestinal fatty acid binding protein (I-FABP)) were evaluated, and visceral adiposity index (VAI) and plasma atherogenic index (PAI) were calculated. Results: The mean age of patients (n = 70) was 55.0 ± 7.55 years. According to FRS, 18.5% of individuals were determined to be at medium–high CVR; a positive correlation was found between BMI, waist–height ratio, body fat ratio, VAI value, and FRS total score (p < 0.05). Serum TMAO, zonulin, and I-FABP levels did not differ between low-risk and medium–high-risk patients (p > 0.05). Serum TMAO, zonulin, and I-FABP levels were positively correlated with TNF-α and IL-6 levels, and serum TMAO and I-FABP levels were positively correlated with triglyceride levels (p < 0.05). Moreover, serum zonulin and I-FABP levels were positively correlated with PAI (p < 0.05). Conclusions: Abdominal obesity and intestinal permeability may affect inflammatory processes and blood lipids in patients with T2DM. Further studies with large samples are needed to examine dietary factors related to the relationship between intestinal permeability and cardiometabolic risk. Full article

Background and Objectives: The objective of this study is to assess the efficacy of a novel software risk score, PulsIn, in predicting cardiovascular diseases within an independent study conducted on subjects from the western region of Romania. Accurate prediction of cardiovascular events in hypertensive patients remains challenging when relying solely on traditional risk scores. This study proposes PulsIn, a composite risk score that integrates classical, echocardiographic, inflammatory, renal, and metabolic markers, combined with machine learning, to refine cardiovascular risk stratification. Materials and Methods: In a prospective cohort of 300 hypertensive adults without prior major cardiovascular events, we collected demographic and clinical data, standard risk factors, laboratory biomarkers (including homocysteine, paraoxonase-1 activity, microalbuminuria, and lipid profile), and advanced echocardiographic parameters (3D left ventricular ejection fraction, diastolic function, global longitudinal strain, and left atrial strain). PulsIn was constructed as an extended composite score and used as input to machine learning models (random forest, XGBoost, and other tree-based algorithms) to predict incident major cardiovascular events. Model performance was assessed by receiver operating characteristic curves, discrimination, calibration, and feature importance and compared with established risk scores (SCORE2, Framingham, QRISK, and others). Results: PulsIn-based models showed improved predictive performance compared with traditional scores, with XGBoost and random forest achieving area under the curve values up to approximately 0.85–0.88, versus 0.60–0.78 for conventional scores. Echocardiographic indices of subclinical cardiac damage, microalbuminuria, homocysteine, and paraoxonase-1 activity emerged as key predictors, particularly enhancing reclassification in patients at intermediate risk by traditional tools. Conclusions: The PulsIn composite risk score, integrating multimodal clinical, echocardiographic, and biomarker data within a machine learning framework, offers more accurate cardiovascular risk prediction than conventional algorithms in hypertensive patients. External validation in larger, independent, and more diverse populations is required before routine clinical implementation. Full article

Background/objectives: Calculation of vascular age can help patients to understand the importance of adherence to a healthy lifestyle and medications. There are different methods of calculating vascular age, but different methods can provide different vascular age results. Our aim was to evaluate vascular age based on the Systematic Coronary Risk Evaluation (SCORE), Systematic Coronary Risk Evaluation 2 (SCORE 2) and Framingham Risk Score (FRS) methods. Methods: Subjects between the ages of 40–65 were involved. Vascular ages were defined based on SCORE, SCORE2 and FRS methods according to data from the literature. Results: In total, 141 patients were involved in the study; among them 94 had hypertension (HT) and 23 had white-coat hypertension. In the total population, SCORE2 and FRS vascular ages were higher compared to chronological age. SCORE2 and FRS vascular ages were higher than SCORE vascular age, and FRS vascular age was higher compared to SCORE2 as well. These tendencies were the same in the case of hypertensive patients and in patients with white-coat hypertension. In healthy patients, there were no differences between chronological age and vascular age. Conclusions: The differences found between the calculated vascular ages and the proportion of subjects with elevated vascular age warrant further comparison of different vascular age calculation methods. Full article

Background: Cardiovascular disease (CVD) is a major complication of systemic lupus erythematosus (SLE). This study compared several CV risk scores in Korean female patients with SLE and searched for an association with subclinical atherosclerosis and lipid metabolism. Methods: Female SLE patients and healthy controls (HCs) underwent carotid ultrasonography and pulse wave velocity (PWV), and serum efflux cholesterol capacity was measured. The Framingham risk scores (FRSs), American College of Cardiology/American Heart Association (ACC/AHA) scores, and Korean Risk Prediction Model (KRPM) scores were calculated. Results: While carotid intima-media thickness (IMT) and the prevalence of carotid plaque did not differ between 67 SLE patients and 37 HCs, carotid plaque scores were higher in SLE patients compared with HCs. While the FRS and the ACC/AHA CV risk scores did not differ, the KRPM scores were higher in SLE patients. The carotid IMT, plaque score, and PWV were correlated with the FRS, ACC/AHA CV risk, and KRPM score in SLE patients. SLE patients with carotid plaque had higher FRS, ACC/AHA CV risk, and KRPM scores than those without carotid plaque. In addition, the serum cholesterol efflux capacity did not differ between SLE patients with and without carotid plaque but was correlated with carotid IMT. Conclusions: The scores obtained from the CV risk-prediction models were correlated with subclinical atherosclerosis in SLE. A cardiovascular risk assessment tool developed specifically for Koreans is suitable for evaluating the CV risk in Korean SLE patients. Full article

Background: Vascular endothelial function is closely related to brain health, especially in individuals with cardiovascular risk factors. In a randomized, crossover clinical trial (NCT04121741), we have previously shown that 30 min of singing improves microvascular endothelial function in older adults with coronary artery disease. Here, we report on secondary and exploratory analyses, including (1) changes in cortisol and cytokine levels and their impact on vascular endothelial function, and (2) the impact of personal music experience on vascular function. Methods: Participants had three study visits separated by 2–7 days, according to a randomized, researcher-blinded, crossover, controlled design: (1) a 30-min period of live singing with an in-person music therapist, (2) a 30-min period of singing along to an instructional video and (3) a 30-min rest (control). Primary outcomes included macrovascular endothelial function assessed by brachial artery flow-mediated dilation (BA FMD%) and microvascular function assessed by peripheral arterial tonometry [Framingham reactive hyperemia index (fRHI) and reactive hyperemia index (RHI)]. Exploratory outcomes included (log) changes in salivary cortisol and cytokine (IL-6, TNF-α, IL-1β, IL-8) levels. Participants were asked to complete the Brief Music Experience Questionnaire (BMEQ), a 53-item validated self-report questionnaire designed to measure an individual’s overall experience with music. The BMEQ assesses how people perceive, react to, and engage with music in various aspects of their lives. Results: Sixty-five subjects (mean age 67.7 ± 6.6 years, 40% female) completed the study. Compared to those subjects completing the BMEQ (n = 31), there were no significant differences in age, sex, race, or presence of diabetes mellitus, hypertension, high cholesterol, heart failure, chronic kidney disease, or chronic respiratory disease in subjects who did not complete the BMEQ (n = 34). Total BMEQ score did not impact changes in BA FMD% (−3.49 ± 2.00, p = 0.086), changes in fRHI (0.58 ± 0.93, p = 0.535), or changes in RHI (0.73 ± 0.65, p = 0.262). When we decompose the sum of squares based on intervention, sex, race, and age, the BMEQ score does not predict changes in vascular function measures. In cross-over analyses, there were no acute changes in salivary cortisol or cytokine levels with 30 min of singing compared to control. Changes in IL-8 were directly related to changes in microvascular endothelial function (0.470 ± 0.184, p = 0.012 for RHI and 0.780 ± 0.248, p = 0.002 for fRHI). Changes in TNF-α were inversely related to changes in fRHI (−0.547 ± 0.263, p = 0.040). Changes in cortisol concentrations were not related to measures of vascular function. Conclusions: The beneficial changes in microvascular endothelial function are not modified by personal music experience in older subjects with known coronary artery disease. There were no changes in salivary cortisol or cytokine levels after 30 min of singing compared to control. Full article

Background/Objectives: As part of the human adaptation to dairy consumption, the presence of the rs4988235-T variant in the MCM6 gene primarily determines lactase persistence in adult European populations, increasing the expression of the lactase-encoding LCT gene. Carriers of the C/C variant are lactose intolerant, while carriers of the T/T or T/C variant have persistent lactase enzyme activity and are able to digest lactose in adulthood. While the association between lactose intolerance and increased cardiovascular risk (CVR) is well-known, the underlying causes have only been partly explored. The present study aimed to investigate the association of rs4988235 polymorphism with significant lipids affecting cardiovascular health and estimated CVR. Methods: The rs4988235 polymorphism was genotyped in 397 subjects from the general Hungarian population and 368 individuals from the Roma population. To characterize the overall lipid profile, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), apolipoprotein AI (ApoAI), and apolipoprotein B100 (ApoB100) levels were measured, and their ratios (TG/HDL-C, LDL-C/HDL-C, and ApoB100/ApoAI) were calculated. Cardiovascular risk was estimated using the Framingham Risk Score (FRS), Pooled Cohort Equations (PCE), Revised Pooled Cohort Equations (RPCE), and the Systematic Coronary Risk Evaluations (SCORE and SCORE2) algorithms. Adjusted linear and logistic regression analyses were performed, with p < 0.05 considered significant. Results: The Roma population had a significantly higher prevalence of the C/C genotype than the general population (65.5% vs. 40.3%, respectively). The results of the adjusted linear regression analysis showed a significant association between the C/C genotype and higher LDL-C level (B = 0.126, p = 0.047) and ApoB100 level (B = 0.046, p = 0.013), as well as a higher LDL-C/HDL-C ratio (B = 0.174, p = 0.021) and a higher ApoB100/ApoAI ratio (B = 0.045, p = 0.002), as well as a lower HDL-C level (B = −0.041, p = 0.049). The C/C genotype was also significantly associated with an increased cardiovascular risk (CVR) as estimated by the SCORE (B = 0.235, p = 0.034), SCORE2 (B = 0.414, p = 0.009), PCE (B = 0.536, p = 0.008), and RPCE (B = 0.289, p = 0.045) but not the FRS. After adjusting the statistical model further for ApoAI and ApoB100 levels, the significant correlation with the risk estimation algorithms disappeared (SCORE: p = 0.099; SCORE2: p = 0.283; PCE: p = 0.255; and RPCE: p = 0.370). Conclusions: Our results suggest that the C/C genotype of rs4988235 is associated with significantly higher ApoB100 and lower ApoAI levels and consequently higher ApoB100/ApoAI ratios, potentially contributing to an increased risk of cardiovascular disease. The results of the statistical analyses suggest that the association between lactose intolerant genotype and cardiovascular risk may be mediated indirectly via modification of the apolipoprotein profile. Full article

Monitoring cardiovascular health enables continuous and real-time risk assessment. This study utilized the Framingham Heart Study dataset to develop and evaluate machine-learning models for predicting mortality risk based on key cardiovascular parameters. Some machine-learning algorithms were applied to multiple machine-learning models. Among these, XGBoost achieved the highest predictive performance, each with an area under the curve (AUC) value of 0.83. Feature importance analysis revealed that coronary artery disease, glucose levels, and diastolic blood pressure (DIABP) were the most significant risk factors associated with mortality. The primary contribution of this research lies in its implications for public health and preventive medicine. By identifying key risk factors, it becomes possible to calculate individual and population-level risk scores and to design targeted early intervention strategies aimed at reducing cardiovascular-related mortality. Full article

Environmental exposures to heavy metals, polychlorinated biphenyls (PCBs), dioxins, and furans have been associated with adverse cardiovascular outcomes, yet their combined effects remain underexplored. This study examined the joint influence of these contaminants on cardiovascular risk indicators in a representative sample of U.S. adults from the 2003–2004 National Health and Nutrition Examination Survey (NHANES). Biomarkers of exposure included lead, cadmium, mercury, twelve PCB congeners, seven dioxins, and ten furans. Cardiovascular outcomes were assessed using blood pressure, Framingham Risk Score (FRS), and lipid profiles. Associations were analyzed using multivariable linear regression and Bayesian Kernel Machine Regression (BKMR), adjusting for age, sex, ethnicity, body mass index, smoking, alcohol consumption, and income. The results demonstrated that metals, particularly mercury, were strongly associated with increased blood pressure and altered HDL cholesterol. PCBs were predominantly linked to elevated systolic blood pressure and FRS, with PCB156 and PCB126 identified as principal contributors. Furans exhibited the strongest associations with dyslipidemia, including elevated LDL cholesterol, total cholesterol, and triglycerides. Combined exposure analysis revealed a complex pattern, with increasing pollutant burdens associated with rising blood pressure and risk scores but declining lipid levels. These findings underscore the outcome-specific effects of pollutant mixtures and suggest that chronic low-level exposure to multiple environmental contaminants may contribute to cardiovascular dysfunction in the general population. Further longitudinal research is needed to confirm these associations and guide risk reduction strategies. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95% CI: 7.40–8.26) and ZJU (OR: 5.91; 95% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships. Full article

Background/Objectives: Vascular function measurements, including central parameters [pulse wave velocity (PWV) and augmentation index (AI)], as well as peripheral measures [finger photoplethysmography fitness index (PPGF)], have been introduced to detect early vascular damage associated with coronary artery disease (CAD) risk factors. This study aimed to compare peripheral and central vascular function marker levels among subjects with hypertension (HPT), dyslipidemia, and obesity. We also aimed to determine the relationship between these markers and CAD risk factors among these groups. Methods: A total of 320 subjects including healthy individuals and those with CAD risk factors were recruited. Peripheral vascular function was assessed using the PPGF, whereas central vascular markers included measurements of PWV and AI. The Framingham risk score (FRS) was calculated using an online calculator. Results: The mean age of the subjects was 33.73 ± 7.29 years. PWV and AI were significantly higher in HPT subjects (8.03 ± 1.40 m/s and 21.90% ± 10.57%) than the control. PPGF levels showed no significant differences between the groups. PWV was associated with FRS in the HPT and dyslipidemia groups, whereas AI was associated with FRS in the obese group. PPGF showed associations with PWV and AI in the dyslipidemia group. Conclusions: PWV and AI serve as robust macrovascular markers indicating arterial stiffness and systemic vascular resistance linked to CAD risk, while PPGF, as a microvascular marker, offers valuable insights into early endothelial dysfunction and microcirculatory anomalies, especially in dyslipidemia subjects. Full article

Objectives: To analyze the effects of the combination of Extra Virgin Olive Oil (EVOO) supplementation and a health-related lifestyle intervention on disease activity and cardiovascular disease risk factors in Systemic Lupus Erythematosus (SLE). Methods: A total of 38 women with SLE were randomly assigned to EVOO (n = 9) and EVOO combined with multicomponent health promotion and physical exercise program (EVOO + HRLI) (n = 15) or control (CG) (n = 14) groups for 24 weeks. Baseline and post-intervention assessments were performed, collecting data on disease activity, accrual damage, blood biochemical parameters, arterial stiffness parameters, Framingham risk score, anthropometric and body composition measurements, and cardiovascular risk factors. Results: No changes in disease activity were observed in any group after the intervention. For cardiovascular risk, significant differences were observed in the intervention groups for systolic and mean blood pressure, with greater reductions in the EVOO + HRLI (p = 0.036 vs. p < 0.001; p = 0.017 vs. p < 0.001, respectively). The EVOO group showed significant reductions in BFM and BFP (p = 0.042, p = 0.022, respectively). The EVOO+ HRLI group also showed significant reductions in triglycerides (p < 0.001), Aix brachial (p = 0.037), central systolic blood pressure (p < 0.001), central pulse pressure (p = 0.05), body mass index (p = 0.006), body fat mass and skeletal muscle mass (p = 0.039) after the intervention. Conclusions: Our findings suggest that a multidisciplinary program integrating nutritional interventions, health education, and the promotion of regular physical activity in SLE patients has the potential to significantly improve cardiovascular risk factors and body composition parameters. Thus, integrating this approach into clinical practice alongside usual pharmacological treatments would be beneficial for SLE patients. Clinical Trial Registration: NCT05261529. Full article

Stroke is a leading cause of death and disability in developed countries. We validated an AI-based prediction model for incident stroke using sensors such as fundus cameras and ophthalmoscopes for retinal images, along with socio-demographic data and traditional risk factors. The model was trained on a proprietary dataset of over 6500 participants, including 171 with 5-year incident strokes and 242 with 10-year incident strokes. The model provides separate 5-year and 10-year risk scores. The model was externally validated on the UK Biobank dataset (3000 subjects with 5-year incident strokes). Using retinal imaging, our models identified individuals with 5-year incident strokes with 80% sensitivity, 82% specificity, and an AUC of 0.83, and predicted 10-year incidents with 72% sensitivity, 78% specificity, and an AUC of 0.79. In comparison, for the 10-year model, the AUC for the Framingham score was 0.73, and the CHADS2 score was 0.74. On the Biobank external dataset, our 5-year model (without retinal features) demonstrated moderate but lower sensitivity (69.3%) and specificity (66.4%) compared to its performance on the proprietary dataset (with retinal features). Using a multi-ethnic dataset, we developed and validated a prediction model that improves stroke risk identification for 5-year and 10-year incidences by incorporating retinal features. Full article

Background/Objectives: Low testosterone levels and low vitamin D status are associated with increased cardiometabolic risk. The purpose of this study was to investigate whether vitamin D status determines the cardiometabolic effects of testosterone replacement therapy. Methods: The study population consisted of three groups of men with late-onset hypogonadism: vitamin D-naive individuals with 25-hydroxyvitamin D levels between 20 and 30 ng/mL (group I), males with 25-hydroxyvitamin D levels between 30 and 60 ng/mL receiving vitamin D supplementation because of previous low vitamin D status (group II), and vitamin D-naïve subjects with 25-hydroxyvitamin D levels between 30 and 60 ng/mL (group III). Circulating levels of total testosterone, 25-hydroxyvitamin D, glucose, insulin, lipids, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, fibrinogen, and urinary albumin-to-creatinine ratio (UACR) were assessed before and six months after intramuscular testosterone administration (250 mg every three weeks). Results: Group I differed from the remaining groups in baseline values of 25-hydroxyvitamin D, hsCRP, homocysteine, fibrinogen, UACR, and the Framingham Risk Score. In all three groups, testosterone injections increased plasma testosterone levels and had a neutral effect on 25-hydroxyvitamin D concentration. In groups II and III, the drug improved insulin sensitivity and reduced LDL cholesterol, uric acid, hsCRP, homocysteine, fibrinogen, and UACR. In group I, the impact of testosterone was limited to a small decrease in HDL cholesterol and hsCRP. Only in groups II and III did testosterone reduce the Framingham Risk Score. There were no differences in the strength of testosterone action between both groups. In groups II and III, the replacement-induced changes in insulin sensitivity, LDL cholesterol, uric acid, hsCRP, homocysteine, fibrinogen, UACR, and the Framingham Risk Score positively correlated with 25-hydroxyvitamin D concentration. Conclusions: The study results suggest that the cardiometabolic effects of exogenous testosterone in men with testosterone deficiency may be determined by vitamin D status. Full article

Background: 8-iso-prostaglandin-F_2α (8-iso-PGF_2α) is a recognized marker of oxidative stress. Previous studies suggested that 8-iso-PGF_2α plays an important role in the pathogenesis of hypertension and cardiovascular (CV) diseases. However, limited data exist on the prognostic role of 8-iso-PGF_2α in hypertensive patients undergoing primary prevention. The aim of this study was to assess the relationship between 8-iso-PGF_2α and 10-year CV risk, as predicted by validated equations in hypertension patients without CV diseases. Materials and methods: A total of 432 individuals aged 40–75 years were enrolled. Plasma 8-iso-PGF_2α was assessed through the ELISA method. CV risk was calculated by using the Framingham Risk Score (Fr-S) and the Atherosclerosis Cardiovascular Disease Risk Score (ASCVD-S). Low, moderate, or high CV risks were defined according to validated cutoffs. Results: Individuals with higher CV risk had significantly greater 8-iso-PGF_2α values compared to those with low or moderate CV risk (p < 0.001). 8-iso-PGF_2α correlated strongly with Fr-S and ASCVD-S in the entire population and in patients with normal renal function (all p < 0.001) but not in patients with eGFR < 60 mL/min/1.73 m². These associations remained significant after adjustment for traditional factors included in the CV risk equations in the overall population and in patients with normal renal function. The 8-iso-PGF_2α cutoffs that best distinguished patients with high CV risk were 310 pg/mL for Fr-S and 264 pg/mL for ASCVD-S in the overall population, with significant differences between the groups divided by eGFR (all p < 0.001). Conclusions: These findings highlight the potential utility of 8-iso-PGF_2α as a biomarker for refining cardiovascular risk stratification in hypertensive patients, particularly those with preserved renal function. Future studies should explore its prognostic value in longitudinal cohorts and assess its integration into clinical risk models to enhance early prevention strategies for cardiovascular disease. Full article