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.

Clonal hematopoiesis:a shared risk factor for cardiovascular diseases and tumors

Clonal hematopoiesis(CH)is a clonally expanded population of hematopoietic stem cells carrying somatic mutations that differentiate through multilineage hematopoiesis to form terminally differentiated mature hematopoietic cells carrying markers of the clonal mutation.Genes integral to critical cellular processes such as epigenetic regulation,DNA damage response,and inflammation frequently carry these mutations.Clonal hematopoiesis becomes increasingly prevalent with age and is associated with an increased risk of hematological tumors and some nonhematological conditions.Recent insights have revealed that the mutations driving CH are not only implicated in hematologic neoplasms but also possess the potential to influence cardiovascular pathogenesis.Here,we reviewed up-to-date findings about the roles of CH in cardiovascular diseases and tumors and explored the clinical significance of CH,as well as look forward to future related studies,so as to provide valuable references for future research and clinical practice.

Effects of loneliness and isolation on cardiovascular diseases:a two sample Mendelian Randomization Study

BACKGROUND Loneliness and isolation are associated with multiple cardiovascular diseases(CVDs),but there is a lack of research on whether they were causally linked.We conducted a Mendelian Randomization(MR)study to explore causal relationships between loneliness and isolation and multiple CVDs.METHODS Single nucleotide polymorphisms associated with loneliness and isolation were identified from a genome-wide association study(GWAS)of 455,364 individuals of European ancestry in the IEU GWAS database.Summary data for 15 CVDs were also obtained from the IEU GWAS database.We used three MR methods including inverse variance weighting,MR-Egger,and weighted median estimation to assess the causal effect of exposure on outcomes.Cochran's Q test and MR-Egger intercept test were used to evaluate the heterogeneity and pleiotropy.RESULTS MR analysis showed that loneliness and isolation were significantly associated with essential hypertension(OR=1.07,95%CI:1.03-1.12),atherosclerotic heart disease(OR=1.04;95%CI:1.02-1.06),myocardial infarction(OR=1.02;95%CI:1-1.04)and angina(OR=1.04;95%CI=1.02-1.06).No heterogeneity and pleiotropy effects were found in this study.CONCLUSIONS Causal relationship of loneliness and isolation with CVDs were found in this study.

Community-based prevention and treatment of cardiovascular diseases

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases(CVD).This section of the report underscores the importance of initiatives outlined in the"Healthy China 2030 Plan,"emphasizing the comprehensive prevention and control strategy for chronic diseases.A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic diseases.By 2020,488 such areas had been set up across China,surpassing the initial target and covering a significant proportion of counties and districts.The report highlights the successful implementation of these strategies in Lishan district,Anshan city,where demonstration areas for comprehensive prevention and control of chronic diseases were launched in 2013.Over the course of seven years,the number of healthy units increased substantially,leading to improvements in managing risk factors for CVD among residents.Significant reductions in prevalence rates of overweight,obesity,smoking,passive smoking,and drinking were observed,along with the development of healthier behaviors among residents.Similarly,Qiaokou district in Wuhan City,designated as a national demonstration area in 2014,implemented comprehensive public health promotion initiatives.Notably,special clinics for hypertension intervention were established,contributing to an increase in self-reported rates of hypertension,a slight decrease in prevalence,and a remarkable improvement in the control rate among treated patients.Overall,these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases,particularly cardiovascular diseases,in China.

Epidemiology and current management of cardiovascular disease in China

The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current management of cardiovascular disease(CVD) in China. This section of the report highlights the epidemiological trends of CVD in China. It reveal a concerning rise in prevalence, with approximately 330 million affected individuals, including significant numbers with stroke, coronary artery disease(CAD), heart failure, and other conditions. CVD stands as the primary cause of mortality among both urban and rural populations, accounting for nearly half of all deaths in 2020. Mortality rates are notably higher in rural areas compared to urban centers since 2009. While age-standardized mortality rates have decreased, the absolute number of CVD deaths has increased, primarily due to population aging. Ischemic heart disease, hemorrhagic and ischemic strokes are the leading causes of CVD-related deaths. Notably, the burden of atherosclerotic cardiovascular disease has risen substantially, with atherosclerotic cardiovascular disease-related deaths increasing from 1990 to 2016. The incidence of ischemic stroke and ischemic heart disease has shown similar increasing trends over the past three decades. CAD mortality, particularly acute myocardial infarction, has been on the rise, with higher mortality rates observed in rural areas since 2016. The prevalence of CAD has increased significantly, with over 11 million patients identified in 2013. Studies assessing hospital performance in managing acute coronary syndrome reveal gaps in adherence to guideline-recommended strategies, with disparities in care quality across hospitals. However, initiatives like the China Patient-centered Evaluative Assessment of Cardiac Events(PEACE)-Retrospective AMI Study and the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS) project aim to improve patient outcomes through enhanced care protocols. Moreover, advancements in medical technology, such as quantitative flow ratio-guided lesion selection during percutaneous coronary intervention, show promise in improving clinical outcomes for patients undergoing intervention.

China cardiovascular diseases report 2015： a summary

1 Introduction Major and profound changes have taken place in China over the past 30 years. An epidemic of cardiovascular diseases （CVD） in China is emerging as a result of lifestyle changes, urbanization, and the accelerated process of aging. The incidence of CVD is continuously increasing and will remain an upward trend in the next decade. Since 2005,

China cardiovascular diseases report 2018: an updated summary

1 Introduction Rapid socioeconomic progress has greatly affected the lifestyle in China.Consequently,owing to lifestyle changes,urbanization,and accelerated population aging,the risk of cardiovascular diseases(CVD)has increased.The incidence of CVD has been increasing continuously and this upward trend is projected to continue in the next decade.The growing burden of CVD has become a major public health issue.

Outline of the Report on Cardiovascular Disease in China,2010

Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases （CVD） are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People＇s Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China （2010）, including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens.

Summary of Report on Cardiovascular Diseases in China,2012

The prevalence of cardiovascular diseases （CVDs） is associated with the socioeconomic prosperity, lifestyle changes, accelerated process of ageing and urbanization. The prevalence of CVDs is continuously increasing in China and will remain an upward trend in the next 10 years. CVDs are the leading cause of death for Chinese in both urban area and rural area. Nowadays, 41.09% of deaths in rural area and 42.52% of deaths in urban area are caused by CVDs in China. The burden of CVDs remains heavy and has become an important public health problem. Effective strategies should be enforced urgently for the prevention of CVDs under the supervision of the government. In 2012, the Ministry of Health of China and 14 governmental departments jointly issued the Work Plan for Chronic Disease Prevention and Control in China （2012-2015）, a guideline for the prevention of chronic diseases, especially CVDs in China.

Beneficial effects of moderate to vigorous physical activity on cardiovascular disease among Chinese adults

Background In China,lack of evidence remains a significant challenge for the national initiative to promote physical activity(PA).We aimed to quantify the beneficial effects of meeting or maintaining the recommended PA level[150 minutes per week(min/wk)of moderate PA or 75 min/wk of vigorous PA or an equivalent combination]on incident cardiovascular disease(CVD)among Chinese population.Methods We included 100,560 participants without history of CVD from three cohorts in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR)project.Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)for CVD events and its subtypes,including stroke,coronary heart disease,heart failure,and CVD death.Results During a median follow-up of 7.3 years(range:6–15 years),777,163 person-years and 4693 incident CVD events were observed.Compared with participants who were inactive at baseline,the multivariable adjusted HR(95%CI)of developing CVD was 0.74(0.69–0.79)for those who met recommended moderate to vigorous physical activity(MVPA)level at baseline.Furthermore,the risk of CVD incidence was reduced with increment of MVPA(Ptrend<0.001),and the HR(95%CI)of highly-active versus inactive category was 0.62(0.56–0.68).Compared with individuals who were inactive both at the baseline and follow-up,those keeping active over the period of follow-up had a substantial lower risk of incident CVD with the HR(95%CI)of 0.57(0.43–0.77).Conclusions The findings demonstrated that meeting and maintaining the recommended MVPA level could reduce the cardiovascular risk.Wider adoption of the PA recommendations would have considerable health impacts to the Chinese population.

The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension:Findings from the Prospective Urban Rural Epidemiology China Study

Background:Both hypertension and grip strength(GS)are predictors of mortality and cardiovascular disease(CVD),but whether these risk factors interact to affect CVD and all-cause mortality is unknown.This study sought to investigate the associations of GS with the risk of major CVD incidence,CVD mortality,and all-cause mortality in patients with hypertension.Methods:GS was measured using a Jamar dynamometer(Sammons Preston,Bolingbrook,IL,USA)in participants aged 3570 years from 12 provinces included in the Prospective Urban Rural Epidemiology China Study.Cox frailty proportional hazards models were used to examine the associations of GS and hypertension and the outcomes of all-cause mortality and CVD incidence/mortality.Results:Among 39,862 participants included in this study,15,964 reported having hypertension,and 9095 had high GS at baseline.After a median follow-up of 8.9 years(interquartile range,6.79.9 years),1822 participants developed major CVD,and 1250 deaths occurred(388 as a result of CVD).Compared with normotensive participants with high GS,hypertensive patients with high GS had a higher risk of major CVD incidence(hazard ratio(HR)=2.39;95%confidence interval(95%CI):1.863.06;p<0.001)or CVD mortality(HR=3.11;95%CI:1.596.06;p<0.001)but did not have a significantly increased risk of all-cause mortality(HR=1.24;95%CI:0.921.68;p=0.159).These risks were further increased if hypertensive participants whose GS level was low(major CVD incidence,HR=3.31,95%CI:2.604.22,p<0.001;CVD mortality,HR=4.99,95%CI:2.649.43,p<0.001;and all-cause mortality,HR=1.93,95%CI:1.472.53,p<0.001).Conclusion:The present study demonstrates that low GS is associated with the highest risk of major CVD incidence,CVD mortality,and all-cause mortality among hypertensive patients.High levels of GS appear to mitigate long-term mortality risk among hypertensive patients.

Advancements in understanding inflammatory responses and the development of cardiovascular diseases under cold stimulation

Cold stimulation has been linked to acute myocardial infarction and other cardiovascular diseases.Residents in the frigid zones,such Heilongjiang Province,experience a higher incidence of adverse cardiovascular events during winter,posing a significant health threat and increasing the overall medical burden.Cold stimulation serves as an detrimental stressor,inducing inflammation in the body.Therefore,understanding the role of inflammatory responses induced by cold stimulation in the occurrence and development of cardiovascular diseases is of paramount importance.Given the impact of cold on inflammation in cardiovascular diseases and the expanding array of anti-inflammatory methods for the treatment of cardiovascular diseases,delving into the inflammatory responses mediated by can significantly complement cardiovascular disease management.This review explorest the synergistic relationship between cold stimulation and inflammation induction,elucidating how this interplay influences the occurrence and progression of cardiovascular diseases.

Microparticles and Cardiovascular Disease

Cardiovascular disease(CVD)is the leading cause of death in China.Even adequate treatment of these risk factors,including hypertension,diabetes mellitus,and smoking,does not completely reduce the risk of CVD.

Pathogenesis and preventive measures of environment-related cardiovascular disease in northern China

Cardiovascular diseases(CVDs)have been the top-ranked cause of human death in the world for years,according to the World Health Organization.Accumulating evidence from epidemiological data supports the view that the risk of CVDs is higher in northern China than in southern area.There is no doubt that living environment has become a crucial factor contributing to the occurrence and progression of CVDs in northern region.However,there have not been any clinical guidelines for the prevention strategy of environment-related CVDs,especially for cold exposure.Thus,there is an urgent need for better understanding of the clinical characteristics and underlying mechanisms of cold-induced CVDs in order to formulate and implement proper and effective measures for minimizing the risk of CVDs for people residing in low-temperature area.Cold exposure,air pollution,lack of sunlight and irrational diet are believed to be crucial factors responsible for environment-related CVDs,and preventive measures might be carried out accordingly to decrease the high risk of CVDs in northern China.

EECP in the treatment of endothelial dysfunction： preventing progression of cardiovascular disease

Enhanced external counterpulsation Extemal counterpulsation （ECP） was originally conceived to be a circulatory assist device to promote blood flow to areas of the heart muscle that were lacking adequate blood supply due to obstruction of the coronary artery. During ECP the lower extremities are compressed to squeeze both arterial and venous blood back to the heart during diastole, increasing coronary perfusion pressure and right ventricular filling. The compression is released during systole,

Global Burden of Cardiovascular Disease

Cardiovascular disease(CVD)is the number one cause of mortality world-wide and places a high medical and socioeconomic burden on developing countries.Our understanding of CVD and its evolution over the last 100 years has altered considerably.Reasons for the increased rate of CVD in the developing world include rapid urbanization and the demographic shift known as the modern epidemiologic transition.The case for intervention is based on both major human and economic impacts of CVD.It has been estimated that cost-effective interventions in developing countries with a high burden of CVD could result in a projected 24 million lives saved.This reduction in CVD mortality could reduce economic costs by$8 billion.Approaches to intervention include:1)cardiovascular health promotion and CVD prevention and 2)action plans advocated by the World Health Organization.

Clinical pharmacology relevant to older adults with cardiovascular disease

1 Introduction Although older adults are generally among the highest users of cardiovascular medications, they are typically underrepresented or excluded from most efficacy and safety trials. Drug developers are usually reluctant to include many senior adults in randomized controlled clinical trials in part due to their high prevalence of multiple comorbidities, frailty, and polypharmacy; and to age-related pharmacokinetic and pharmacodynamic complexities. Consequently, there is often insufficient high quality evidence-based data to inform pharmacologic management of common cardiovascular conditions on older adults. In the absence of data, clinicians often rely on conceptual principles regarding metabolism and drug-drug interactions to minimize adverse drug events, but this is often not well-substantiated or standardized. A related challenge is poor cardiovascular medication adherence among older adults, and its detrimental impact on their health outcomes. In this brief review we highlight some aspects of these topics.

The association of cardiovascular mortality with a first-degree family member history of different cardiovascular diseases

OBJECTIVE To investigate which history of cardiovascular disease[coronary heart disease(CHD),stroke,or peripheral arterial disease]in a first-degree family member predicts cardiovascular mortality.METHODS We studied a prospective cohort(the Lipid Research Clinics Prevalence Study)from ten primary care centers across North America.The primary outcome was cardiovascular mortality,assessed using Cox survival models.RESULTS There were 8,646 participants(mean age:47.4±12.1 years,46%women,52%of participants with hyperlipidemia)who were followed up for a mean duration of 19.4±4.9 years.There were 1,851 deaths(21%),including 852 cardiovascular deaths.A paternal,maternal or sibling history of premature CHD(before 60 years)was present in 26%of participants,of stroke in 27%of participants,and of peripheral arterial disease in 24%of participants.After adjusting for risk factors(age,sex,systolic blood pressure,diastolic blood pressure,body mass index,smoking,fasting glucose,low-density lipoprotein cholesterol and triglycerides),only a paternal history of premature or any CHD,a maternal history of diabetes mellitus or premature or any CHD,and a sibling history of premature CHD,hypertension,or hyperlipidemia were individually predictive of cardiovascular mortality.After adjusting for risk factors and the mentioned familial factors,only paternal and maternal histories of CHD,espe-cially before 60 years,remained predictive of cardiovascular mortality,with a somewhat higher association for a maternal history[adjusted hazard ratio(aHR)=1.99,95%CI:1.36−2.92,P<0.001 for maternal history of premature CHD;aHR=1.52,95%CI:1.10−2.10,P=0.011 for paternal history of premature CHD].Family history of stroke or peripheral arterial disease did not predict cardiovascular mortality.Parental history of premature CHD predicted cardiovascular mortality independently of baseline age(<60 years and≥60 years),hypertension,or hyperlipidemia and carried more important prognostic value in men rather than wo-men.CONCLUSIONS In this study,a parental history of CHD,especially before 60 years,best predicted cardiovascular mortality.This finding could help more accurately identify high-risk patients who would benefit from preventive strategies.

Regional Variations in Medication Usage for Cardiovascular Diseases at the Community Level in China (PURE-China Study)

We investigated the usage of secondary prevention drugs and traditional Chinese medicine （TCM） products in individuals with cardiovascular diseases （CVDs） at the community level in China. Among 2,407 participants with self-reported coronary heart disease （CHD） and 872 with stroke, nearly 80% of individuals with CHD and 73% of individuals with stroke were not taking any proven secondary prevention drug. However, 32.9% of them took TCM products. Patients with CVDs in rural areas used less secondary prevention treatment, but more TCM products than their counterparts in the urban regions. After adjusting for confounding factors, lower rates of secondary prevention treatment were evident in Western China compared with Eastern China, which was more developed. Systematic change is needed to promote the development of evidence-based medicine at the community level in China.

Anti-cytomegalovirus antibodies and other atherosclerosis risk factors in patients with cardiovascular diseases

Objective To determine anti-cytomegalovirus(CMV) antibodies along with anti-Chlamydia pneumoniae(CP) antibodies in comparison with inflammatory markers and other risk factors of atherosclerosis in patients with selected cardiovascular diseases(CVD) . Methods A total of 228 patients with coronary heart disease(CHD) and/or hyperten-sion(HT) ,and those who underwent reconstructive vascular surgery(RVS) on carotids or abdominal aorta were tested for the presence of anti-CMV IgG and IgM antibodies as well as for anti-CP IgA antibodies,C-reactive protein(CRP) ,and interleukin-6(IL-6) . Other risk factors for atherosclerosis,namely age,gender,smoking,hypercholesterolemia,and diabetes mellitus were also analyzed. Results Anti-CMV IgG antibodies were found in 204 patients sera(89.5%) ,compared with 46 positive of 68 sera in the controls(67.6%) ,whereas anti-CMV IgM antibodies were detected in 4 of 54 sera of patients tested(7.4%) ,but not in the controls. The highest proportion of positive sera with not only anti-CMV IgG antibodies(95.6.7%) ,but also anti-CP IgA antibodies(78.3%) ,IL-6(84.8%) and CRP(97.8%) ,was observed in patients with RVS. The results obtained corresponded to age,hypercholesterolemia,and diabetes. Conclusions The presence of anti-CMV antibodies together with antibodies to CP and markers of inflammation(CRP and IL-6) in our study was associated with CVD,primarily in elderly patients who underwent RVS.