The Importance of Setting Treatment Goals for Cardiovascular Diseases

Background: Guidelines are issued by most major organizations that focus on a specific disease entity. Guidelines should be a significant help to the practicing physician who may not be up-to-date with the recent medical literature. Unfortunately, when conflicting guidelines for a specific disease are published, confusion results. Purpose: This article provides a suggested guideline outcome measure that would benefit the physician and patient. Methods: A review of 19 different guidelines for cardiovascular disease treatment is one example of the lack of specific outcomes that currently exist. The basic problem with most guidelines is that they do not state the expected end result (i.e., the benefit to the patient) if that guideline is followed. When guidelines use cardiovascular disease risk factors to dictate therapy, the end benefit is never stated so that the patient can make an appropriate choice of which (if any) guideline to follow. Results: A good example is guidelines published by the American Heart Association for reducing cardiovascular disease. These guidelines are risk factor based and only indicate that cardiovascular disease would be reduced if followed. No specific percentage in the reduction of the incidence of disease is given. In contrast, when elimination of the disease is the stated goal of the guideline, the end result is clear. To date, this goal has been stated by only one organization devoted to eliminating cardiovascular disease. Conclusion: Guidelines need to be written to provide the physician and the patient with a specific end point that is expected when the guideline is followed. Patient acceptance and compliance will be much improved if the patient knows the risk/benefit of following the guideline’s recommendations.

Analysis of The Impact of The Healthcare Roundtable Model on the Major Disease Perceptions and Competencies of Cardiovascular Medicine Nursing Staff

Objective: To analyze the impact of the healthcare roundtable model on the major disease perceptions and competencies of cardiovascular nursing staff. Methods: Forty female nursing staff working in the hospital from April to June 2023 were selected and were randomly divided into a control group and an observation group, with 20 in each group. For 60 days, the control group used the conventional learning and communication model and the observation group used the medical and nursing roundtable model. The cognitive scores of cardiovascular disease-related knowledge, competency scores, and satisfaction with the learning and communication model before and after the implementation of the model in both groups were compared. Results: After the implementation, the cognitive scores related to cardiovascular disease-related knowledge, competency scores, and satisfaction with the learning and communication model in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The healthcare roundtable model improved the knowledge and competence of cardiovascular internal medicine nursing staff in major diseases, and it is worth popularizing.

The association of diet quality and physical activity with cardiovascular disease and mortality in 85,545 older Australians:A longitudinal study

Background:A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease(CVD)prevention.However,despite their interlinked effects on metabolic health,the 2 behaviors are rarely considered jointly,particularly within the context of CVD prevention.We examined the independent,interactive,and joint associations of diet and physical activity with CVD hospitalization,CVD mortality,and all-cause mortality.Methods:CVD-free Australian participants aged 4574 years(n=85,545)reported physical activity,diet,sociodemographic,and lifestyle characteristics at baseline(20062009)and follow-up(20122015),and data were linked to hospitalization and death registries(03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality).Diet quality was categorized as low,medium,and high based on meeting dietary recommendations.Physical activity was operationalized as(a)total moderate-to-vigorous physical activity(MVPA)as per guidelines,and(b)the composition of MVPA as the ratio of vigorous-intensity physical activity(VPA)to total MVPA.We used a left-truncated cause-specific Cox proportional hazards model using time-varying covariates.Results:During a median of 10.7 years of follow-up,6576 participants were admitted to the hospital for CVD and 6581 died from all causes(876 from CVD during 9.3 years).A high-quality diet was associated with a 17%lower risk of all-cause mortality than a low-quality diet,and the highest MVPA category(compared with the lowest)was associated with a 44%and 48%lower risk of CVD and all-cause mortality,respectively.Multiplicative interactions between diet and physical activity were non-significant.For all outcomes,the lowest risk combinations involved a high-quality diet and the highest MVPA categories.Accounting for total MVPA,some VPA was associated with further risk reduction of CVD hospitalization and all-cause mortality.Conclusion:For CVD prevention and longevity,one should adhere to both a healthy diet and an active lifestyle and incorporate some VPA when possible.

Age-specific differences in the association between prediabetes and cardiovascular diseases in China:A national cross-sectional study

BACKGROUND Cardiovascular disease(CVD)is a leading cause of morbidity and mortality worldwide,the global burden of which is rising.It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults.To develop a focused screening plan and treatment for Chinese adults with prediabetes,it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age.AIM To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China.METHODS The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008.A thorough evaluation was conducted.Individuals with prediabetes were categorized into two groups based on age.Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years.Random forest was established in both age groups.SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution.RESULTS In total,6948 people were diagnosed with prediabetes in this study.In prediabetes,prevalences of CVD were 5(0.29%)in the younger group and 148(2.85%)in the older group.Overall,11.11%of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years.In the younger age group,the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle,whereas in the older age group,resident status was more closely linked.CONCLUSION The susceptibility to CVD is age-specific in newly diagnosed prediabetes.It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.

Occupational physical activity, all-cause, cardiovascular disease, and cancer mortality in 349,248 adults: Prospective and longitudinal analyses of the MJ Cohort

Background:Evidence on the health benefits of occupational physical activity(OPA)is inconclusive.We examined the associations of baseline OPA and OPA changes with all-cause,cardiovascular disease(CVD),and cancer mortality and survival times.Methods:This study included prospective and longitudinal data from the MJ Cohort,comprising adults over 18 years recruited in 1998-2016,349,248 adults(177,314 women)with baseline OPA,of whom 105,715(52,503 women)had 2 OPA measures at 6.3±4.2 years(mean±SD)apart.Exposures were baseline OPA,OPA changes,and baseline leisure-time physical activity.Results:Over a mean mortality follow-up of 16.2±5.5 years for men and 16.4±5.4 years for women,11,696 deaths(2033 of CVD and 4631 of cancer causes)in men and 8980 deaths(1475 of CVD and 3689 of cancer causes)in women occurred.Combined moderately heavy/heavy baseline OPA was beneficially associated with all-cause mortality in men(multivariable-adjusted hazard ratio(HR)=0.93,95%confidence interval(95%CI):0.89-0.98 compared to light OPA)and women(HR=0.86,95%CI:0.79-0.93).Over a mean mortality follow-up of 12.5±4.6 years for men and 12.6±4.6 years for women,OPA decreases in men were detrimentally associated(HR=1.16,95%CI:1.01-1.33)with all-cause mortality,while OPA increases in women were beneficially(HR=0.83,95%CI:0.70-0.97)associated with the same outcome.Baseline or changes in OPA showed no associations with CVD or cancer mortality.Conclusion:Higher baseline OPA was beneficially associated with all-cause mortality risk in both men and women.Our longitudinal OPA analyses partly confirmed the prospective findings,with some discordance between sex groups.

Relationship of Ambient Humidity with Cardiovascular Diseases:A Prospective Study of 24,510 Adults in a General Population

Objective This study aimed to explore the association between humidity exposure and the risk of cardiovascular disease(CVD),utilizing follow-up data and relative humidity(RH)metric assessments.Methods We extracted the baseline data from the China Hypertension Survey(CHS)of 24,510 enrolled participants aged≥35 years without a history of CVD between 2012 and 2015 and followed them up from 2018 to 2019.The National Meteorological Information Center(NMIC)of the China Meteorological Administration(CMA)provided the quality-controlled relative humidity(RH)datasets.Cox proportional hazards models were used to estimate hazard ratios(HRs)for CVD in relation to RH.Results During the follow-up period(2018-2019),973 patients with CVD were identified.The HR of CVD risk was 1.17(95%CI:1.04-1.31)per 10%increase in summer mean RH.Compared with participants in the 3rd quintile group,those in the 1st and 5th quintiles of RH had a higher risk of CVD.For summer mean RH,the HRs(95%CIs)for the 1st and 5th quintiles were 1.34(1.04-1.71)and 1.44(1.14-1.83),respectively.The relationship(“U”shape)between summer mean RH and the risk of CVD was nonlinear.Stratified analyses indicated that the risk of CVD was substantially influenced by the summer mean RH in female,older individuals,and those in southern China.Conclusion Unsuitable(too high or low)humidity environments affect the risk of CVD.Our study highlights those future policies for adapting to climate change should consider the humidity-CVD relationship.

The impact of perception bias for cardiovascular disease risk on physical activity and dietary habits

Objective:Cardiovascular disease(CVD)remains a significant public health challenge in China.Accurateperception of individual CVD risk is crucial for timely intervention and preventive strategies.This studyaimed to determine the alignment between CVD risk perception levels and objectively calculated CVDrisk levels,then investigate the disparity in physical activity and healthy diet habits among distinct CVDrisk perception categories.Methods:From March to August 2022,a cross-sectional survey was conducted in Zhejiang Province usingconvenience sampling.Participants aged between 20 and 80 years,without prior diagnosis of CVD wereincluded.CVD risk perception was evaluated with the Chinese version of the Attitude and Beliefs aboutCardiovascular Disease Risk Perception Questionnaire,while objective CVD risk was assessed through thePrediction for Atherosclerotic Cardiovascular Disease Risk(China-PAR)model.Participants’demographicinformation,self-reported physical activity,and healthy diet score were also collected.Results:A total of 739 participants were included in the final analysis.Less than a third of participants(29.2%)accurately perceived their CVD risk,while 64.5%over-perceived it and 6.2%under-perceived it.Notably,half of the individuals(50.0%)with high CVD risk under-perceived their actual risk.Compared tothe accurate perception group,individuals aged 60e80 years old(OR=6.569),currently drinking(OR=3.059),and with hypertension(OR=2.352)were more likely to under-perceive their CVD risk.Meanwhile,participants aged 40-<60 years old(OR=2.462)and employed(OR=2.352)were morelikely to over-perceive their risk.The proportion of individuals engaging in physical activity was lowest inthe under-perception group,although the difference among the three groups was not statistically significant(X^(2)=2.556,P=0.278).In addition,the proportion of individuals practicing healthy diet habitswas also lowest in the under-perception group,and a significant statistical difference was observedamong the three groups(X^(2)=10.310,P=0.006).Conclusion:Only a small proportion of participants accurately perceived their CVD risk,especially amongthose with high actual CVD risk.Individuals in the under-perceived CVD risk group exhibited the lowestrates of physical activity engagement and healthy diet adherence.Healthcare professionals should prioritize implementing personalized CVD risk communication strategies tailored to specific subgroups toenhance the accuracy of risk perception.

Health system interventions for the cost containment of drugs used for cardiovascular diseases: a systematic review and exploration of how the results could be adapted to the Sri Lankan context

Objectives:Cardiovascular disease(CVD)in low and middle-income countries(LMICs),accounts for over 80%of global CVD-related deaths.The high cost of drugs is a major concern in not of managing CVD.This study aimed to conduct a comprehensive review to identify interventions for cost containment of cvD drugs and use the inter-vention scalability assessment tool(ISAT)to examine the acceptability and application of relevant interventions in the Sri Lankan context,that can also be adaptable to other LMICs.Methods:A systematic search across three databases(Medline,Web of Science and Embase)was completed to identify relevant health system interventions.The ISAT assessed the feasibility of adapting the identified interven-tions to Sri Lanka,using structured interviews with 25 Sri Lankan stakeholders representing five groups:health managers,cardiologists,pharmacists,nursing officers,and patients.Results:The search yielded nine publications.Five were conducted on a national scale,while others were con-ducted at the regional levels.Seven were published in developed countries.The identified interventions were categorised into six intervention themes:Imposing a ceiling price or reference price;introduction of the polypill;introduction of volume price contract initiatives;prescribing generic and essential drugs;one intervention pack-age including generics,essential medicine,90-day drugs,and free delivery;and a second intervention package including discounts,rebates,cost-free medicine,and bundling.Assessment of six intervention themes revealed that methods of setting ceiling prices and controlling generic drug prescribing were the most popular,while other interventions were least popular..Conclusions:The study provides a roadmap for future interventions based on successful scaling,emphasizing the importance of understanding contextual variables and encourages stakeholder participation in policy assessments and advocacy.The findings highlighted the potential for enhancing the access to affordable CVD drugs not only in Sri Lanka,but also adaptable to other LMICs.These outcomes can contribute to policy decisions,aimed at reducing the significant global burden of CVD.

Protective effects of oleic acid and polyphenols in extra virgin olive oil on cardiovascular diseases

The Mediterranean diet has long been recognized as one of the most effective ways to prevent and improve cardiovascular disease.Extra virgin olive oil(EVOO)is the typical sources of fat in the Mediterranean diet which have been shown to have noteworthy nutritional value and positive impact on human health.It is worth noting that EVOO owes its superior nutritional value to its bioactive composition.The main component of EVOO is monounsaturated fatty acids(MUFAs)in the form of oleic acid.Oleic acid accounts for up to 70%-80%of EVOO.Secondly,EVOO contains approximately more than 30 phenolic compounds,of which HT is essential for the protection against cardiovascular diseases.In this review,we focused on the potential mechanisms of oleic acid and polyphenols combat cardiovascular diseases risk in terms of oxidative stress,inflammation,blood pressure,endothelial function and cholesterol.This review might provide a reference for the studies on cardiovascular protective effects of EVOO.

Soluble ST2:A Novel Biomarker for Diagnosis and Prognosis of Cardiovascular Disease

The increasing incidence of cardiovascular disease(CVD)is a significant global health concern,affecting millions of individuals each year.Accurate diagnosis of acute CVD poses a formidable challenge,as misdiagnosis can significantly decrease patient survival rates.Traditional biomarkers have played a vital role in the diagnosis and prognosis of CVDs,but they can be influenced by various factors,such as age,sex,and renal function.Soluble ST2(sST2)is a novel biomarker that is closely associated with different CVDs.Its low reference change value makes it suitable for continuous measurement,unaffected by age,kidney function,and other confounding factors,facilitating risk stratification of CVDs.Furthermore,the combination of sST2 with other biomarkers can enhance diagnostic accuracy and prognostic value.This review aims to provide a comprehensive overview of sST2,focusing on its diagnostic and prognostic value as a myocardial marker for different types of CVDs and discussing the current limitations of sST2.

Wnt/β-catenin Signaling Cascades in Cardiovascular Diseases

Cardiovascular diseases are a group of disorders of the heart and blood vessels,primarily including coronary heart disease,stroke,and other diseases.It is the world’s leading cause of death,and its incidence is increasing yearly.Hypertension is a major risk factor for cardiovascular disease.Wnt signaling comprises a series of highly conservative cascading events controlling fundamental biological processes.Wnt signaling pathways include the canonical Wnt pathway(or Wnt/β-catenin pathway),the non canonical planar cell-polarity pathway,and the non-canonical calcium-dependent pathways.Abnormal Wnt signaling promotes cell proliferation and differentiation,cardiac malformations,various malignancies,so drugs targeting Wnt signaling play a great therapeutic potential.Wnt/β-catenin pathway is involved in the occurrence and development of cardiovascular diseases such as atherosclerosis and stroke by regulating cell proliferation,migration,apoptosis,blood-brain barrier permeability,inflammation,oxidative stress,and immune response.Based on the latest research progress,this review summarizes the role of Wnt/β-catenin signaling in cardiovascular diseases,in order to provide new ideas for the prevention and treatment of cardiovascular diseases.

Cardiovascular diseases in European ethnic minorities: Beyond the traditional cardiovascular risk factors

This editorial is intended to be a reflection on cardiovascular disease(CVD)burden in European ethnic minorities.In some European countries,ethnic minority realities,due to their recent appearance,are still to be studied in depth.The experience of several European countries,where the migration processes started earlier,even more than a century ago,can help by being an example.Many studies have shown that major differences in CVD burden exist not only between countries,but also within the same country when considering different social strata and ethnic groups.The CV risk factors underlying heart disease have been well established.Important epidemiological studies have helped us understand that the underlying causes of heart disease as well as the behaviors that can help prevent them are the same.We are now well aware that CVD should be treated by considering a holistic approach.This is why the social determinants(SDs)of health that may worsen the disease burden or that,vice versa,may improve the treatment,and even more significantly,the prognosis of a patient’s illness should be taken into consideration.For ethnic minority patients,this holistic,hermeneutic approach is of importance.Several SDs of health that influence CVDs have been identified but their relevance for the health of ethnic minorities has not yet been clearly defined.In some European countries,most ethnic minorities are largely also religious minorities.Only a few studies have evaluated the role of religion,which is an important SD that affects the probability of having CV risk factors and diseases.Adolescents,particularly those belonging to the second generation,seem to be the weak link.If we believe that these young people are really citizens of their country of birth,then a way of recognizing their belonging to the community starts from a will to better understand their condition,in order to assist them while they grow physically and mentally.Thinking about safeguarding the health of this population should be more than a health task,rather a goal of social justice.

Experience of humanistic nursing in hemodialysis nursing for patients with diabetic kidney disease

BACKGROUND Diabetic kidney disease(DKD)is a prevalent complication of diabetes that often requires hemodialysis for treatment.In the field of nursing,there is a growing recognition of the importance of humanistic care,which focuses on the holistic needs of patients,including their emotional,psychological,and social well-being.However,the application of humanistic nursing in the context of hemodialysis for DKD patients remains relatively unexplored.AIM To explore the experience of humanistic nursing in hemodialysis nursing for DKD patients.METHODS Ninety-six DKD patients treated with hemodialysis from March 2020 to June 2022 were included in the study and divided into the control cluster(48 cases)and the study cluster(48 cases)according to different nursing methods;the control cluster was given routine nursing and the study cluster was given humanized nursing.The variances of negative emotion mark,blood glucose,renal function,the incidence of complications,life mark and nursing satisfaction before and after nur-sing were contrasted between the two clusters.RESULTS No significant difference in negative emotion markers between the two clusters were observed before nursing(P>0.05),and the negative emotion markers of the two clusters decreased after nursing.The Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale markers were lower in the study cluster than the control cluster.The healing rate of patients in the study cluster was significantly higher than the control cluster(97.92%vs 85.42%,P<0.05).Blood glucose parameters were not significantly different between the groups prior to nursing(P>0.05).However,after nursing,blood urea nitrogen and serum creatinine(SCr)levels in the study cluster were lower than those in the control cluster(P<0.05).The incidence rate of complications was significantly lower in the study group compared to the control cluster(6.25%vs 20.83%,P<0.05).There was no significant difference in the life markers between the two clusters before nursing.While the life markers increased after nursing for both groups,the 36-item health scale markers in the study cluster were higher than those within the control cluster(P<0.05).Finally,the nursing satisfaction rate was 93.75% in the study cluster,compared to 75% in the control cluster(P<0.05).CONCLUSION In hemodialysis for DKD patients,the implementation of humanistic nursing achieved ideal results,effectively reducing patients’psychological negative emotion markers so that they can actively cooperate with the diagnosis and nursing,facilitate the control of blood glucose and the maintenance of residual renal function,reduce the occurrence of complications,and finally enhance the life quality and nursing satisfaction of patients.It is worthy of being widely popularized and applied.

Clinical effects of detailed nursing management interventions on medication adherence and disease perception in patients with drugresistant tuberculosis

BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.

Age-specific heterogeneity of genetic susceptibility to cardiovascular disease might have opposite outcomes depending on the presence of prediabetes

Examining age-specific heterogeneity of susceptibility to cardiovascular disease is also essential in individuals without prediabetes to determine its relative size and direction compared to those with prediabetes.Of particular interest,age-specific heterogeneity in genetic susceptibility may exhibit opposite directions depending on the presence or absence of prediabetes.

New understanding of using“heart adjusting acupuncture method”to prevent and treat atherosclerotic cardiovascular disease

This article explores the foundational research,Chinese medicine theories,and clinical applications of the“heart adjusting acupuncture method”developed by Professor Guanhu Yang to prevent and treat athero-sclerotic cardiovascular disease(ASCVD).Professor Yang established this method based on experimental studies involving electroacupuncture along the horizontal umbilical line,which demonstrated a reduction in infarct area in the myocardial infarction mice model.This method was formulated using acupoints on the horizontal umbilical line:Daimai(GB 26),Tianshu(ST 25),and Daheng(SP 15).Clinical application has shown that it could effectively improve cardiac function and manage various cardiovascular conditions and proposed a new hypothesis for the treatment of myocardial infarction.Further research is required to determine if electroacupuncture stimulation at the site of myocardial infarction or during transportation can extend the critical treatment window,preserve myocardial tissue,and enhance reperfusion therapy prognosis.Professor Yang advocates that,when combined with active Western medicine treatments,the“heart adjusting acupuncture method”offers an effective measure to prevent and treat ASCVD.

Update on evidence-based clinical application of sodium-glucose cotransporter inhibitors:Insight to uncommon cardiovascular disease scenarios in diabetes

In this paper,we concentrate on updating the clinical research on sodium-glucose cotransporter inhibitors(SGLTis)for patients with type 2 diabetes who have heart failure with a preserved injection fraction,acute heart failure,atrial fibrillation,primary prevention of atherosclerotic cardiovascular disease/cardiovascular disease,and acute myocardial infarction.We searched the data of randomized controlled trials and meta-analyses of SGLTis in patients with diabetes from PubMed between January 1,2020 and April 6,2024 for our review.According to our review,certain SGLTis(empagliflozin,dapagliflozin,canagliflozin,and tofogliflozin),but not sodium-glucose cotransporter 1 inhibitor(SGLT1i),exhibit relatively superior clinical safety and effectiveness for treating the abovementioned diseases.Proper utilization of SGLTis in these patients can foster clinical improvement and offer an alternative medication option.However,clinical trials involving SGLTis for certain diseases have relatively small sample sizes,brief intervention durations,and conclusions based on weak evidence,necessitating additional data.These findings are significant and valuable for providing a more comprehensive reference and new possibilities for the clinical utilization and scientific exploration of SGLTis.

Natural product-based treatment potential for type 2 diabetes mellitus and cardiovascular disease

BACKGROUND Type 2 diabetes(T2D)is a metabolic disease of impaired glucose utilization and a major cause of cardiovascular disease(CVD).The pathogenesis of both diseases shares common risk factors and mechanisms,and both are significant contributors to global morbidity and mortality.Supplements of natural products for T2D mellitus(T2DM)and CVD can be seen as a potential preventive and effective therapeutic strategy.AIM To critically evaluate the therapeutic potential of natural products in T2D and coronary artery disease(CAD).METHODS By using specific keywords,we strategically searched the PubMed database.Randomized controlled trials(RCTs)were searched as the primary focus that examined the effect of natural products on glycemic control,oxidative stress,and antioxidant levels.We focused on outcomes such as low blood glucose levels,adjustment on markers of oxidative stress and antioxidants.After screening fulllength papers,we included 9 RCTs in our review that met our inclusion criteria.RESULTS In the literature search on the database,we found that various natural products like plant secondary metabolites play a diverse role in the management of CAD.American ginseng,sesame oil and cocoa flavanols proved effective in lowering blood glucose levels and controlling blood pressure,which are key factors in managing T2DM and CVD.In diabetic patients Melissa officinalis effectively reduce inflammation and shows diabetes prevention.Both fish oil and flaxseed oil reduced insulin levels and inflammatory markers,suggesting benefits for both conditions.The lipid profile and endothelial function were enhanced by Nigella sativa oil and Terminalia chebula,which is significant for the management of cardiovascular risk factors in T2DM.Additionally Bilberry extract also showed promise for improving glycemic control in patients with T2DM.CONCLUSION The high level of antioxidant,anti-inflammatory,and anti-angiogenic properties found in natural products makes them promising therapeutic options for the management of CAD,with the potential benefit of lowering the risk of CAD.

Improving Prediction Efficiency of Machine Learning Models for Cardiovascular Disease in IoST-Based Systems through Hyperparameter Optimization

This study explores the impact of hyperparameter optimization on machine learning models for predicting cardiovascular disease using data from an IoST(Internet of Sensing Things)device.Ten distinct machine learning approaches were implemented and systematically evaluated before and after hyperparameter tuning.Significant improvements were observed across various models,with SVM and Neural Networks consistently showing enhanced performance metrics such as F1-Score,recall,and precision.The study underscores the critical role of tailored hyperparameter tuning in optimizing these models,revealing diverse outcomes among algorithms.Decision Trees and Random Forests exhibited stable performance throughout the evaluation.While enhancing accuracy,hyperparameter optimization also led to increased execution time.Visual representations and comprehensive results support the findings,confirming the hypothesis that optimizing parameters can effectively enhance predictive capabilities in cardiovascular disease.This research contributes to advancing the understanding and application of machine learning in healthcare,particularly in improving predictive accuracy for cardiovascular disease management and intervention strategies.

Molecular and metabolic landscape of adenosine triphosphateinduced cell death in cardiovascular disease

The maintenance of intracellular and extracellular adenosine triphosphate(ATP)levels plays a pivotal role in cardiac function.In recent years,burgeoning at-tention has been directed towards ATP-induced cell death(AICD),revealing it as a distinct cellular demise pathway triggered by heightened extracellular ATP concentrations,distinguishing it from other forms of cell death such as apoptosis and necrosis.AICD is increasingly acknowledged as a critical mechanism me-diating the pathogenesis and progression of various cardiovascular maladies,encompassing myocardial ischemia-reperfusion injury,sepsis-induced cardiomy-opathy,hypertrophic cardiomyopathy,arrhythmia,and diabetic cardiomyopathy.Consequently,a comprehensive understanding of the molecular and metabolic underpinnings of AICD in cardiac tissue holds promise for the prevention and amelioration of cardiovascular diseases.This review first elucidates the vital physiological roles of ATP in the cardiovascular system,subsequently delving into the intricate molecular mechanisms and metabolic signatures governing AICD.Furthermore,it addresses the potential therapeutic targets implicated in mitigating AICD for treating cardiovascular diseases,while also delineating the current constraints and future avenues for these innovative therapeutic targets,thereby furnishing novel insights and strategies for the prevention and management of cardiovascular disorders.