Search Results (25)

Influenza has long been a well-documented contributor to cardiovascular morbidity and mortality, particularly among high-risk groups. COVID-19 has notably altered the seasonality and natural history of pandemic influenza, with broad implications for related cardiac complications. This review examines the interaction between influenza and cardiovascular illness, especially myocardial infarction, congestive heart failure, stroke, and other acute cardiac events. We review the impact of the COVID-19 pandemic on influenza transmission dynamics, public health policy, and the evolving burden of cardiovascular complications. New evidence indicates that both diseases exacerbate endothelial dysfunction, systemic inflammation, and prothrombotic states, thereby increasing cardiovascular risk. A comparative analysis of pre- and post-COVID-19 influenza-related cardiac complications clarifies evolving trends and guides future preventive strategies. In light of the recent resurgence of influenza following the relaxation of COVID-19 mitigation measures, maximizing vaccine coverage and collaborating to manage viral infections in patients with cardiovascular disease are critical. This review focuses on key research needs to understand long-term cardiac consequences and the urgent requirement for targeted public health strategies to counter viral-mediated cardiovascular threats. In the post-COVID era, integrating influenza and COVID-19 vaccination strategies into cardiovascular risk management may represent a critical opportunity to reduce virus-triggered cardiovascular morbidity and mortality. Full article

Elevation in the level of whole blood viscosity (WBV) is a known contributor to cardiovascular risk. Moreover, cardiovascular diseases are associated with seasonal variation and the potential impact of seasonal changes on blood viscosity, and associated biomolecules pose substantial cardiovascular risk and are therefore a subject of interest. To evaluate the effect of seasonal changes on whole blood viscosity, glycated haemoglobin and associated biomolecules, namely haematocrit and serum total protein, and their implications on management of diabetic cardiovascular risk are explored. This was a clinical laboratory retrospective observational study involving 10-year pathology data (1999–2008) which estimated whole blood viscosity (eWBV) and the associated biomolecules, namely haematocrit and serum total protein. Comparisons were made between seasonal changes and glycated haemoglobin, whole blood viscosity, haematocrit, and serum total protein levels. Whole blood viscosity, haematocrit, and serum total protein levels increased with colder seasons (p < 0.001), peaking in the winter. However, the seasonal variation in the level of glycated haemoglobin did not achieve statistical significance. Blood viscosity fluctuates between seasons, with peaks occurring in the winter season. This fluctuation will assist in adjusting monitoring and treatment strategies of diabetic risks seasonally. In addition, recognition of seasonal variations will help in precise risk assessment of timely interventions to mitigate the risk of cardiovascular events in diabetes management. Full article

Air pollution is a global issue affecting health and the environment. This study investigated associations between PM₁₀, NO₂, and admissions from cardiovascular and respiratory diseases in Makkah (2019–2022), comparing Hajj cultural events and the COVID-19 lockdown with non-event periods, using time-series Poisson regression models adjusted for time and seasonality. Event interactions, particularly the impact of the Hajj and COVID-19 periods, were examined to assess potential effects on morbidity. The study findings showed that PM₁₀ was significantly associated with increased respiratory admissions during the Hajj period (lag 0: RR = 1.066; 95% CI: 1.030–1.104), and with decreased risk during the non-Hajj period (lag 0: RR = 0.966; 95% CI: 0.942–0.991) and non-COVID periods (lag 0: RR = 0.946; 95% CI: 0.920–0.973). NO₂ demonstrated a strong positive association with respiratory admissions during the Hajj period across all lags, peaking at lag 0 with a 16.2% increased risk (RR = 1.162; 95% CI: 1.118–1.207). Exposure to PM₁₀ during Hajj was associated with a 3.1% increased risk of cardiovascular admissions (lag 0: RR = 1.031; 95% CI: 1.012–1.050) and decreased risk during non-Hajj (lag 0: RR = 0.981; 95% CI: 0.963–0.999) and non-COVID periods (lag 0: RR = 0.962; 95% CI: 0.942–0.983). NO₂ exposure was positively associated with cardiovascular admissions during Hajj (lag 0: RR = 1.039; 95% CI: 1.019–1.056) and non-COVID periods (lag 0: RR = 1.037; 95% CI: 1.007–1.068). These findings provide event-specific evidence to guide targeted air quality management during mass gatherings, helping policymakers protect the health of Makkah’s residents and visitors. Full article

This study investigates the impact of injuries on National Basketball Association (NBA) player performance over 20 seasons, using large-scale performance data and a statistical evaluation. Injury events were matched with player–game performance metrics to assess how various injury types influence short-, medium-, and long-term performance outcomes, measured across 2-, 5-, and 10-game windows. Using paired sample t-tests and Cohen’s d, we quantified both the statistical significance and effect size of changes in key performance metrics before and after injury. The analysis applies paired t-tests and Cohen’s d to quantify the statistical and practical significance of performance deviations pre- and post-injury. Our results show that while most injury types are associated with measurable performance declines, especially in offensive and defensive ratings, certain categories, such as cardiovascular injuries, demonstrate counterintuitive improvements post-recovery. These patterns suggest that not all injuries have equivalent consequences and highlight the importance of individualized recovery protocols. This work contributes to the growing field of sports injury analytics by combining statistical modeling and sports analytics to deliver actionable insights for coaches, medical staff, and performance analysts in managing player rehabilitation and optimizing return-to-play decisions. Full article

Background: Elderly patients with chronic lower respiratory diseases (CLRDs) demonstrate an increased susceptibility to complications arising from influenza. Influenza vaccination remains the most effective strategy against influenza-related diseases among elderly CLRD patients. This study aimed to evaluate the influenza vaccination status of older CLRD patients and the factors affecting influenza vaccination. Methods: Using population-based health registries, we analyzed the longitudinal uptake of influenza vaccination among elderly patients with CLRDs in Ningbo from the 2018/19 season to the 2022/23 season. A multivariate logistic regression analysis was performed to identify behavioral determinants influencing influenza vaccination among elderly CLRD patients under Ningbo’s post-pandemic free vaccination policy. Results: An average of 487,309 older patients with CLRDs were included in our analysis for each season. The influenza vaccination rate increased from 3.59% in 2018/19 to 43.32% in the 2022/23 influenza season. There was a significant increase in the proportion of timely influenza vaccinations prior to November 15, rising from 3.01% before the COVID-19 pandemic to 33.90% during the pandemic period. The multivariate logistic regression analysis indicated that both the COVID-19 pandemic and free vaccination policy significantly promoted influenza vaccine uptake. Older CLRD patients with comorbidities such as diabetes, hypertension, or cancer exhibited higher influenza vaccination coverage, whereas those who have experienced acute cardiovascular events showed a lower vaccination rate. Additionally, a prior vaccination history significantly influenced uptake. Conclusions: Despite the significant improvement in vaccination rates, coverage among elderly patients with CLRDs remains below the WHO target. Addressing this gap requires integrated interventions that combine expanding the population eligible for free vaccinations, community mobilization efforts, and effective communication regarding cardiovascular safety to mitigate vaccine hesitancy within high-risk groups. Full article

The activities of living beings fluctuate according to seasonal changes and circadian rhythms. The interaction of organisms with their environment, notably weather conditions and night–day cycles, modulate homeostatic mechanisms and influence physiological responses in stressful situations. In humans, it is well established that cardiovascular events such as myocardial infarction, stroke and acute heart failure more frequently occur in winter than in summer season (non-tropical regions) and in the morning than in the evening. While the effects of cardiovascular medications vary during the day, the influence of circadian rhythms on the outcomes of invasive interventions is the subject of conflicting debates. This paper analyzes the impact of seasonal variability and circadian rhythms on physiological responses and the occurrence of complications in cardiac surgery and interventional cardiology. Full article

Plaque erosion (PE), a distinct etiology of acute coronary syndromes (ACSs), is often overshadowed by plaque ruptures (PRs). Concerning its epidemiology, PE has garnered increasing recognition, with recent studies revealing its prevalence to be approximately 40% among ACS patients, challenging earlier assumptions based on autopsy data. Notably, PE exhibits distinct epidemiological features, preferentially affecting younger demographics, particularly women, and often manifesting as a non-ST-segment elevation myocardial infarction. There are seasonal variations, with PE events being less common in winter, potentially linked to physiological changes and cholesterol solidification, while peaking in summer, warranting further investigation. Moving to molecular mechanisms, PE presents a unique profile characterized by a lesser degree of inflammation compared to PR, with endothelial shear stress emerging as a plausible molecular mechanism. Neutrophil activation, toll-like receptor-2 pathways, and hyaluronidase 2 expression are among the factors implicated in PE pathophysiology, underscoring its multifactorial nature. Advancements in intravascular imaging diagnostics, particularly optical coherence tomography and near-infrared spectroscopy coupled with intravascular ultrasound, offer unprecedented insights into plaque composition and morphology. Artificial intelligence algorithms show promise in enhancing diagnostic accuracy and streamlining image interpretation, augmenting clinician decision-making. Therapeutically, the management of PE evolves, with studies exploring less invasive approaches such as antithrombotic therapy without stenting, particularly in cases identified early through intravascular imaging. Additionally, the potential role of drug-coated balloons in reducing thrombus burden and minimizing future major adverse cardiovascular events warrants further investigation. Looking ahead, the integration of advanced imaging modalities, biomarkers, and artificial intelligence promises to revolutionize the diagnosis and treatment of coronary PE, ushering in a new era of personalized and precise cardiovascular care. Full article

Background: The occurrence of compound hot extreme (CHE) events in China is increasingly frequent. This study aimed to investigate the association between CHEs and all-cause mortality in Shandong Province and to estimate the attributable excess deaths. Methods: We collected daily data on weather, air pollution, and all-cause mortality at the subdistrict level in Shandong Province from 2013 to 2018. A CHE was defined as both daily maximum and minimum temperatures being higher than their historical 90th percentiles during 2013–2018 hot seasons. A case time-series analysis with a distributed lagged non-linear model was applied to analyze the subdistrict-specific association between different hot extremes and mortality risk, which were then pooled at the province level using meta-analysis. Results: Hot nights (RR = 1.44, 95%CI: 1.35–1.53) and CHEs (RR = 1.77, 95%CI: 1.64–1.90) were significantly associated with an increased mortality risk. CHEs had a greater effect for females (RR = 1.99, 95%CI: 1.81–2.19) and the elderly (>74 years) (RR = 2.14, 95%CI: 1.93–2.38) than their counterparts, respectively. Cardiovascular and respiratory deaths were more susceptible to CHEs than other deaths. Each year, 4888 (95%CI: 4133–5811) excess deaths in Shandong Province were attributable to CHEs, accounting for 2.60% (95%CI: 2.20–3.10%) of all-cause deaths and equating to 50 (95%CI: 42–58) deaths per 1,000,000 residents. The CHE-related mortality burden varied across subdistricts, with the highest occurring in the southeastern area and the lowest occurring in the northeastern and southwestern regions. Conclusion: CHEs and hot nights were substantially associated with excess deaths in Shandong Province, especially for females, the elderly, and residents living in the southeastern area. Our findings may facilitate the development of a heat alert warning system and preventive measures for vulnerable populations. Full article

Despite enormous global efforts within clinical research and medical practice to reduce cardiovascular disease(s) (CVD), it still remains the leading cause of death worldwide. While genetic factors clearly contribute to CVD etiology, the preponderance of epidemiological data indicate that a major common denominator among diverse ethnic populations from around the world contributing to CVD is the composite of Western lifestyle cofactors, particularly Western diets (high saturated fat/simple sugar [particularly high fructose and sucrose and to a lesser extent glucose] diets), psychosocial stress, depression, and altered sleep/wake architecture. Such Western lifestyle cofactors are potent drivers for the increased risk of metabolic syndrome and its attendant downstream CVD. The central nervous system (CNS) evolved to respond to and anticipate changes in the external (and internal) environment to adapt survival mechanisms to perceived stresses (challenges to normal biological function), including the aforementioned Western lifestyle cofactors. Within the CNS of vertebrates in the wild, the biological clock circuitry surveils the environment and has evolved mechanisms for the induction of the obese, insulin-resistant state as a survival mechanism against an anticipated ensuing season of low/no food availability. The peripheral tissues utilize fat as an energy source under muscle insulin resistance, while increased hepatic insulin resistance more readily supplies glucose to the brain. This neural clock function also orchestrates the reversal of the obese, insulin-resistant condition when the low food availability season ends. The circadian neural network that produces these seasonal shifts in metabolism is also responsive to Western lifestyle stressors that drive the CNS clock into survival mode. A major component of this natural or Western lifestyle stressor-induced CNS clock neurophysiological shift potentiating the obese, insulin-resistant state is a diminution of the circadian peak of dopaminergic input activity to the pacemaker clock center, suprachiasmatic nucleus. Pharmacologically preventing this loss of circadian peak dopaminergic activity both prevents and reverses existing metabolic syndrome in a wide variety of animal models of the disorder, including high fat-fed animals. Clinically, across a variety of different study designs, circadian-timed bromocriptine-QR (quick release) (a unique formulation of micronized bromocriptine—a dopamine D2 receptor agonist) therapy of type 2 diabetes subjects improved hyperglycemia, hyperlipidemia, hypertension, immune sterile inflammation, and/or adverse cardiovascular event rate. The present review details the seminal circadian science investigations delineating important roles for CNS circadian peak dopaminergic activity in the regulation of peripheral fuel metabolism and cardiovascular biology and also summarizes the clinical study findings of bromocriptine-QR therapy on cardiometabolic outcomes in type 2 diabetes subjects. Full article

A narrative review on the interlinking effects of climate change and air pollution, and their impacts on human health in the Arabian Peninsula and its Neighbouring Regions (APNR) is provided. The APNR is experiencing the direct impacts of climate change through increasingly extreme temperatures in the summer season, increasing maximum and minimum temperatures, and increased frequency and severity of dust events. The region is also experiencing significant air pollution, of which particulate matter (PM), nitrogen dioxide (NO₂) and sulphur dioxide (SO₂) are of specific concern. Air pollution in the APNR is mainly caused by unprecedented industrial, population and motorization growth. The discovery of oil in the early 20th century has been the major economic driving force behind these changes. Climate change and air pollution impact human health in the region, primarily respiratory and cardiovascular health. Despite an increase in research capacity, research intensity was found to be inconsistent across the APNR countries, with Saudi Arabia, the UAE, Qatar and Iraq publishing more research articles than the other countries. In this review article, the existing research gaps in the region are investigated and the lack of synthesis between the interacting effects of air pollution and climate change upon human health is highlighted. Full article

Strokes are the second most common cause of death worldwide and a leading cause of disability. Regular consumption of polyphenols has been shown to reduce the risk of suffering a cardiovascular event. For this reason, we have investigated the protective effect of Salicornia ramosissima, a seasonal halophyte that synthetizes high amounts of bioactive compounds, including polyphenols, in response to environmental stress. Aqueous, hydroalcoholic, and ethanolic extracts were prepared to investigate if dietary supplementation prior to ischemic challenge can prevent subsequent damage using two animal models. First, we screened the protective effect against hypoxia–reoxygenation in Drosophila melanogaster and observed that both ethanolic and hydroalcoholic extracts protected flies from the deleterious effects of hypoxia. Second, we confirmed the protective effect of S. ramosissima ethanolic extract against brain ischemia using the transient middle cerebral artery occlusion mice model. Four weeks of oral supplementation with the ethanolic extract before artery occlusion reduced infarct volume and lowered the plasma levels of the DNA peroxidant product 8-hydroxydeoxyguanosine. Phytochemical profiling of S. ramosissima ethanolic extract revealed 50 compounds. Thus, it represents a valuable source of bioactive compounds that show promising disease-modifying activities and could be further developed as an effective food supplement for the prevention or treatment of neurovascular disorders. Full article

Circadian rhythms have been identified in cardiovascular diseases, and cardiovascular risk factors can modify the circadian rhythm. The purpose of this study was to describe the onset of ischaemic heart disease symptomatology in relation to the date and time, the day of the week of presentation, the season, AMI location and severity and the level of influence of individual patient characteristics in a retrospective cross-sectional study involving 244 ischaemic heart disease patients from the intensive care unit of La Ribera Hospital (Spain). The onset of pain was more frequent in the morning, the season with the highest frequency of ischaemic events was winter, and the lowest incidence was during weekends. Regarding the severity of ischaemic heart disease, the circadian rhythm variables of weekdays vs. weekends and seasons did not show a significant association. The length of hospital stay was associated with the onset of pain in the afternoon. The onset of pain at night was associated with the subendocardial location of the infarction. In conclusion, living in a Mediterranean country, the Spanish population showed a circadian pattern of AMI, where the onset of pain has an influence on AMI location and on the length of hospital stay and is the same in patients with different individual risk factors. Full article

The association between days with similar environmental parameters and cardiovascular events is unknown. We investigate the association between clusters of environmental parameters and acute myocardial infarction (AMI) risk in Singapore. Using k-means clustering and conditional Poisson models, we grouped calendar days from 2010 to 2015 based on rainfall, temperature, wind speed and the Pollutant Standards Index (PSI) and compared the incidence rate ratios (IRR) of AMI across the clusters using a time-stratified case-crossover design. Three distinct clusters were formed with Cluster 1 having high wind speed, Cluster 2 high rainfall, and Cluster 3 high temperature and PSI. Compared to Cluster 1, Cluster 3 had a higher AMI incidence with IRR 1.04 (95% confidence interval 1.01–1.07), but no significant difference was found between Cluster 1 and Cluster 2. Subgroup analyses showed that increased AMI incidence was significant only among those with age ≥65, male, non-smokers, non-ST elevation AMI (NSTEMI), history of hyperlipidemia and no history of ischemic heart disease, diabetes or hypertension. In conclusion, we found that AMI incidence, especially NSTEMI, is likely to be higher on days with high temperature and PSI. These findings have public health implications for AMI prevention and emergency health services delivery during the seasonal Southeast Asian transboundary haze. Full article

The Kherson, Mykolaiv, Odesa, and Zaporizhzhia oblasts, being adjusted to the coasts of the Black and Azov Seas, are located in the steppe zone and constitute the southern region of Ukraine. The environmental parameters and health indicators of the population of the region are sensitive to the impact of natural (e.g., climate change) and anthropogenic processes. An analysis of satellite remote sensing data (NOAA NDVI time series) for the assessment of vegetation condition demonstrates an increase in frequency and duration of drought events in the region during the last few decades. It may have a relation to climate change processes. Data analysis of local meteorological observations over the past 100 years proved alterations of some bioclimatic indexes. The Equivalent Effective Temperature (I_EET) increases in winter and summer (due to the increasing repeatability of high anomalous temperatures) and remains stable in spring and autumn seasons. The increasing number and variability of climate anomalies can provoke an increase in cardiovascular and some other diseases in the local population. At the same time, an analysis of the statistical data of health indicators of the population (such as morbidity of digestion, breathing, and the endocrine and circulatory systems) shows a tendency to decrease morbidity (contrary to the indicators of the mountain regions’ population, which have higher values of life expectancy). Interrelations between environmental, climate change, and population health indicators in the Black Sea region are being discussed. Full article

Optimal use of Hierarchical Bayesian Model (HBM)-assembled aerosol optical depth (AOD)-PM_2.5 fused surfaces in epidemiologic studies requires homogeneous temporal and spatial fused surfaces. No analytical method is available to evaluate spatial heterogeneity. The temporal case-crossover design was modified to assess the spatial association between four experimental AOD-PM_2.5 fused surfaces and four respiratory–cardiovascular hospital events in 12 km² grids. The maximum number of adjacent lag grids with significant odds ratios (ORs) identified homogeneous spatial areas (HOSAs). The largest HOSA included five grids (lag grids 04; 720 km²) and the smallest HOSA contained two grids (lag grids 01; 288 km²). Emergency department asthma and inpatient asthma, myocardial infarction, and heart failure ORs were significantly higher in rural grids without air monitors than in urban grids with air monitors at lag grids 0, 1, and 01. Rural grids had higher AOD-PM_2.5 concentration levels, population density, and poverty percentages than urban grids. Warm season ORs were significantly higher than cold season ORs for all health outcomes at lag grids 0, 1, 01, and 04. The possibility of elevated fine and ultrafine PM and other demographic and environmental risk factors synergistically contributing to elevated respiratory–cardiovascular chronic diseases in persons residing in rural areas was discussed. Full article